Individual provider Active NPI

Sheryl Ann Hedges, NP,PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
National Provider Identifier
1427065234
Registry record updated Feb 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
090007034N6 Issued in OR
Practice address
12710 SE Division St.
Portland, OR 97236
Phone
(503) 988-3601
Fax
(503) 988-4098
NPI assigned
Aug 2, 2006
Last updated
Feb 26, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 090007034N6 OR
Community Health Nurse Practitioner 363LC1500X 090007034N6 OR
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 090007034N6 OR Primary

Addresses

Primary practice location

12710 SE Division St.
Portland, OR 97236

Mailing address

421 SW Oak St.
210
Portland, OR 97204
Phone (503) 988-3663

Other identifiers 1

IdentifierTypeStateIssuer
292317MedicaidOR

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
090007034N6ORMDCommunity Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cascadia Health Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267142400000",
    "number": "1427065234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 SW OAK ST.",
            "address_2": "210",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97204",
            "telephone_number": "503-988-3663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12710 SE DIVISION ST.",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97236",
            "telephone_number": "503-988-3601",
            "fax_number": "503-988-4098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDGES",
        "first_name": "SHERYL",
        "middle_name": "ANN",
        "credential": "NP,PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2010-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "090007034N6",
            "primary": false
        },
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": "OR",
            "license": "090007034N6",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "090007034N6",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292317",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2010; 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.