Roxanne M Payne, FNP
Individual provider Active NPI Family Nurse Practitioner · Portland, OR
NPI 1295040905 · NPPES record last updated Oct 19, 2020
Key facts
- NPI
- 1295040905
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 200750084NP (OR)
- Practice address
- 4805 NE Glisan St
Main Level
Portland, OR 97213-2933 - Phone
- (503) 215-7901
- NPI assigned
- Aug 18, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101124001070 | OR | Practitioner - Nurse Practitioner | 6800082223 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200750084NP | OR | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Health & Services Oregon | Current | Accepting new patients | |
| Providence Health & Services Oregon | Current | Accepting new patients | |
| Providence Health & Services Oregon | Current |
Accepting new patients | |
| Providence Health & Services Oregon | Current |
Accepting new patients | |
| Providence Health & Services - Oregon | Current |
Accepting new patients | |
| Providence Health & Services Oregon | Current |
Accepting new patients | |
| Providence Health & Services Oregon | Current |
Accepting new patients | |
| Providence Health & Services Oregon | Current |
Accepting new patients | |
| Providence Health & Services Oregon | Past | Accepting new patients | |
| Providence Health & Services - Oregon | Past | Accepting new patients |
Locations
810 12th St
Hood River, OR 97031
Phone (541) 386-3911
1003 N Providence Dr
Ste 325
Newberg, OR 97132
Phone (503) 216-1661
5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405
9135 SW Barnes Rd
Ste 261
Portland, OR 97225
Phone (503) 215-8650
4805 NE Glisan St
Ste 11N
Portland, OR 97213
Phone (503) 215-1350
9427 SW Barnes Rd
Portland, OR 97225
Phone (503) 203-2040
10330 SE 32nd Ave
Ste 205
Portland, OR 97222
Phone (503) 513-8950
9155 SW Barnes Rd
Ste 238
Portland, OR 97225
Phone (503) 223-7214
5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480
1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250
4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111
727 S Wahanna Rd
Ste 100
Seaside, OR 97138
Phone (503) 717-7000
725 S Wahanna Rd
Seaside, OR 97138
Phone (503) 717-7000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 200750084NP | OR | Yes |
Addresses
Primary practice location
4805 NE Glisan St
Main Level
Portland, OR 97213-2933
Mailing address
PO Box 3158
Portland, OR 97208-3158
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rpayne109900@oc.providencedirect.org |
Other providers in Portland, OR
- Kelsey Smith Payne
- Kimberly Dawn Payne
- Lisa Marie Payne
- Molly Payne
- Pepita Louise Payne
- Susan D Payne
- Todd E. Payne
- Tyson Dee Payne Payne
- Kelly Nelson Paynter
- Nathan Payton
All providers in Portland, OR · Family Nurse Practitioner in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 19, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.