Individual provider Active NPI

Cynthia Vermillion Deckert, NURSE

  • Registered Nurse
  • Salem, OR
National Provider Identifier
1407988967
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
Practice address
3225 State St
Salem, OR 97301-5063
Phone
(503) 584-2301
NPI assigned
Mar 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X OR Primary

Addresses

Primary practice location

3225 State St
Salem, OR 97301-5063

Mailing address

PO Box 367
82936 Oak Dr
Dexter, OR 97431-0367
Phone (503) 539-4363

Other names 1

  • Cynthia Annita Vermillion Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
083039799ORMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1173571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407988967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 367",
            "address_2": "82936 OAK DR",
            "city": "DEXTER",
            "state": "OR",
            "postal_code": "974310367",
            "telephone_number": "503-539-4363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 STATE ST",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973015063",
            "telephone_number": "503-584-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECKERT",
        "first_name": "CYNTHIA",
        "middle_name": "VERMILLION",
        "credential": "NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CYNTHIA",
            "last_name": "VERMILLION",
            "middle_name": "ANNITA",
            "credential": "NURSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.