Individual provider Active NPI

Alexa Christine Smith-Ellison, RN, CNM, WHNP

  • Advanced Practice Midwife
  • Bend, OR
National Provider Identifier
1366835670
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
235726 Issued in CA
Practice address
2400 NE Neff Rd Ste a
Bend, OR 97701-6752
Phone
(541) 389-3300
Fax
(541) 389-8115
NPI assigned
Mar 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 95002125 CA
Advanced Practice Midwife 367A00000X 235726 CA Primary

Addresses

Primary practice location

2400 NE Neff Rd Ste a
Bend, OR 97701-6752

Mailing address

2400 NE Neff Rd Ste a
Bend, OR 97701-6752
Phone (541) 389-3300

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211221002131 OR Practitioner - Certified Nurse Midwife (CNM) 1456670777 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Cascade Womens Group P CGroup PAC ID 9638166796, 18 clinicians

Practice addresses (Care Compare)

2400 NE Neff Rd
Suite a
Bend, OR 97701-6752
Phone (541) 389-3300

Hospital & facility affiliations

  • St Charles Medical Center - Bend Hospital, Bend, OR, CCN 380047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife, Registered Nurse

State licenses

LicenseStateTypeSpecialty
95002125CAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
East Cascade Womens Group, P C CurrentSince Oct 1, 2021 Accepting new patients
St. Charles Health System, Inc. Past Accepting new patients
St. Charles Health System, Inc. PastSince Oct 1, 2021 Accepting new patients

Locations

2400 NE Neff Rd
Ste A
Bend, OR 97701
Phone (541) 389-3300

Interoperability endpoints

  • Direct secure messaging: asmithellison24435@coipa.gardenplot.direct-ci.com
  • Direct secure messaging: asmithellison297443@hisp.ehr.sutterhealth.org
  • FHIR API: https://epicproxy.et4001.epichosted.com/APIProxyPRD/ECWG/api/FHIR/R4

Organizations & group practices 3

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.

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": "1426032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1366835670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 NE NEFF RD STE A",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016752",
            "telephone_number": "541-389-3300",
            "fax_number": "541-389-8115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 NE NEFF RD STE A",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016752",
            "telephone_number": "541-389-3300",
            "fax_number": "541-389-8115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH-ELLISON",
        "first_name": "ALEXA",
        "middle_name": "CHRISTINE",
        "name_prefix": "Ms.",
        "credential": "RN, CNM, WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-11",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "95002125",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "235726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.