Olivia Shea Anderson
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Lebanon, OR
NPI 1386103604 · NPPES record last updated Dec 27, 2021
Key facts
- NPI
- 1386103604
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 200 Mullins Dr
Lebanon, OR 97355-3983 - Phone
- (541) 259-0235
- NPI assigned
- Mar 16, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260302001493 | CA | Order and Referring Only - Family Practice |
5496237273 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
200 Mullins Dr
Lebanon, OR 97355-3983
Mailing address
200 Mullins Dr
Lebanon, OR 97355-3983
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Other providers in Lebanon, OR
- Richard L. Alley
- Victoria Grace Rodgers Allsup
- Carolina Del Socorro Amador
- Richard Howell Ames
- Alex Charles Anderson
- Steven Blaine Anderson
- Katherine Andrews
- Kim Andrews
- Lacee Andrews
- Animal Clinic
All providers in Lebanon, OR · Student in an Organized Health Care Education/Training Program in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 27, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.