Chanida Putwanphen Wilson

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

202215285NP-PP Issued in OR

Practice address

1100 7TH Ave SW
Albany, OR 97321-1925

Phone

(541) 812-5600

NPI assigned

Jul 30, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

93.65 of 100Reported as group

Quality

86.8

Promoting interoperability

100

Improvement activities

40

Cost

86.36

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: cwilson264684@samhealth.direct-ci.com

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

{
    "created_epoch": "1659139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1376279323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 7TH AVE SW",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211925",
            "telephone_number": "541-812-5600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2222 Maroneal St Unit 1333",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770303266",
            "country_code": "US",
            "telephone_number": "210-501-2688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CHANIDA",
        "middle_name": "PUTWANPHEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-30",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1061486",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "61302785",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "202215285NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cwilson264684@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "1100 7th Ave SW",
            "city": "Albany",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973211925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tina Joanne Williamson, FNP-C
• Aaron Austin Williford, CRM
• Willoughby Hearing Aid Centers
• Sharron Wilsey
• Tracy Michelle Wilson Rinerson
• Dina Wilson, DO
• Gabriel Wilson
• Jennifer Marie Wilson, FNP-C
• Megan Wilson, DPT
• Shelly Wilson

• Nurse Practitioner in Albany, OR
• Providers in Albany, OR by specialty
• Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.