Individual provider Active NPI

Lee Ann Chamberlain, FNP

  • Family Nurse Practitioner
  • Redmond, OR
National Provider Identifier
1336524941
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201504872NP-PP Issued in OR
Practice address
1250 SW Veterans Way Ste 120
Redmond, OR 97756-2588
Phone
(541) 383-3005
Fax
(541) 383-1883
NPI assigned
Jul 24, 2015
Last updated
Oct 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Health Clinical Nurse Specialist 364SF0001X 201504872NP OR
Family Nurse Practitioner 363LF0000X 201504872NP-PP OR Primary

Addresses

Primary practice location

1250 SW Veterans Way Ste 120
Redmond, OR 97756-2588

Mailing address

PO Box 4228
Portland, OR 97208-4228
Phone (541) 383-3005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20150923002654 OR Practitioner - Nurse Practitioner 8820305881 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mosaic Community HealthGroup PAC ID 5395653497, 78 clinicians

Practice addresses (Care Compare)

1250 SW Veterans Way
Redmond, OR 97756-2585
Phone (541) 383-3005

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
201504872NPORMDFamily Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Mosaic Community Health CurrentSince Nov 13, 2023 Accepting new patients
Icco, LLC Current Accepting new patients
Icco LLC CurrentSince Sep 1, 2022 Accepting new patients
Icco, LLC CurrentSince Sep 1, 2022 Accepting new patients
Mosaic Medical Dental PastSince Nov 13, 2023 Accepting new patients

Locations

108 NW Sisemore St
Ste 120
Bend, OR 97703
Phone (541) 213-2133

2577 NE Courtney Dr
Bend, OR 97701
Phone (541) 322-7400

598 E 13th Ave
Eugene, OR 97401
Phone (541) 636-3473

375 NW Beaver St
Ste 101
Prineville, OR 97754
Phone (541) 316-6026

1250 SW Veterans Way
Ste 120
Redmond, OR 97756
Phone (541) 408-9486

1555 S Highway 97
#101
Redmond, OR 97756
Phone (541) 204-4304

244 NW Kingwood Ave
Redmond, OR 97756
Phone (541) 316-2500

3818 SW 21st St
Ste 100
Redmond, OR 97756
Phone (541) 548-2899

Organizations & group practices 5

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1437696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1336524941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4228",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084228",
            "telephone_number": "541-383-3005",
            "fax_number": "541-383-1883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 SW VETERANS WAY STE 120",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977562588",
            "telephone_number": "541-383-3005",
            "fax_number": "541-383-1883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERLAIN",
        "first_name": "LEE",
        "middle_name": "ANN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-24",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "OR",
            "license": "201504872NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201504872NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, OR

Sources for this page

Verify at the official NPI Registry.