Individual provider Active NPI

Alexandra Marie Sigmon, NP

  • Nurse Practitioner
  • Gresham, OR
National Provider Identifier
1295248003
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5010448 Issued in NC
Practice address
2850 SE Powell Valley Rd
Gresham, OR 97080-1494
Phone
(503) 666-5050
NPI assigned
Nov 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 202003830NP-PP OR
Family Nurse Practitioner 363LF0000X 95007929 CA
Nurse Practitioner 363L00000X 5010448 NC Primary

Addresses

Primary practice location

2850 SE Powell Valley Rd
Gresham, OR 97080-1494

Mailing address

2850 SE Powell Valley Rd
Gresham, OR 97080-1494
Phone (503) 666-5050

Other practice location 1

1113 Alta Ave
Upland, CA 91786-2800
Phone (909) 206-5956

Other practice location 2

11840 Southmore Dr Ste 100
Charlotte, NC 28277-4821
Phone (980) 308-0169

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address asigmon44191@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180717002806 NC Practitioner - Nurse Practitioner 9537416987 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5010448NCMDNurse Practitioner
95007929CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SCRN LLC CurrentSince May 9, 2018 Accepting new patients

Locations

3007 Wesley Chapel Stouts Rd
Ste B
Monroe, NC 28110
Phone (704) 412-3612

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1510704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1295248003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 SE POWELL VALLEY RD",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970801494",
            "telephone_number": "503-666-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 SE POWELL VALLEY RD",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970801494",
            "telephone_number": "503-666-5050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1113 Alta Ave",
            "address_purpose": "LOCATION",
            "city": "Upland",
            "state": "CA",
            "postal_code": "917862800",
            "country_code": "US",
            "telephone_number": "909-206-5956",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11840 Southmore Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282774821",
            "country_code": "US",
            "telephone_number": "980-308-0169",
            "fax_number": "980-308-0173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIGMON",
        "first_name": "ALEXANDRA",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-15",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "202003830NP-PP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95007929",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5010448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "asigmon44191@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1113 Alta Ave",
            "city": "Upland",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917862800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

Verify at the official NPI Registry.