Individual provider Active NPI

Cristina Capannolo, DO

  • Family Medicine Physician
  • Roseburg, OR
National Provider Identifier
1346627510
Registry record updated Jul 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO194623 Issued in OR
Practice address
3031 NE Stephens St
Roseburg, OR 97470-6237
Phone
(541) 229-7038
NPI assigned
Apr 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X DO194623 OR Primary
Family Medicine Physician 207Q00000X 177234 OR

Addresses

Primary practice location

3031 NE Stephens St
Roseburg, OR 97470-6237

Mailing address

3600 NW Samaritan Dr
Graduate Medical Education Attn: Chrissy Anderson
Corvallis, OR 97330-3737
Phone (541) 768-4906

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190809001646 OR Practitioner - Family Practice 8921392929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Umpqua Health Newton Creek LLCGroup PAC ID 4284915141, 9 clinicians

Practice addresses (Care Compare)

3031 NE Stephens St
Roseburg, OR 97470-6237
Phone (541) 229-7038

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
177234ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Umpqua Health Newton Creek, LLC CurrentSince Sep 1, 2019 Accepting new patients

Locations

3031 NE Stephens St
Roseburg, OR 97470
Phone (541) 229-7038

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JCEJBD
  • Direct secure messaging: cristina.capannolo@uhnc.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1430092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1346627510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 NW SAMARITAN DR",
            "address_2": "GRADUATE MEDICAL EDUCATION ATTN: CHRISSY ANDERSON",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303737",
            "telephone_number": "541-768-4906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 NE STEPHENS ST",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974706237",
            "telephone_number": "541-229-7038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPANNOLO",
        "first_name": "CRISTINA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-27",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO194623",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "177234",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

Verify at the official NPI Registry.