Individual provider Active NPI

Virginia Foreman, SLP

  • Speech-Language Pathologist
  • Milton Freewater, OR
National Provider Identifier
1457569717
Registry record updated Apr 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
012876 Issued in OR
Practice address
120 Elzora St
Milton Freewater, OR 97862-9454
Phone
(541) 938-3318
NPI assigned
May 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X LL00003806 WA
Speech-Language Pathologist 235Z00000X 012876 OR Primary

Addresses

Primary practice location

120 Elzora St
Milton Freewater, OR 97862-9454

Mailing address

PO Box 577
Conway, WA 98238-0577
Phone (360) 920-2549

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231013000613 OR Practitioner - Qualified Speech Language Pathologist 6800241647 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehab Specialists Outpatient LLCGroup PAC ID 6507254497, 46 clinicians

Practice addresses (Care Compare)

1417 SE 107TH Ave
Portland, OR 97216-3156
Phone (503) 408-0404

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
012876ORMDSpeech-Language Pathologist
LL00003806WAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab Specialists Outpatient, LLC Speech-Language Pathologist Current Accepting new patients
Rehab Specialists Outpatient, LLC Speech-Language Pathologist CurrentSince Jun 1, 2025 Accepting new patients
Select Rehabilitation, LLC Speech-Language Pathologist CurrentSince Sep 1, 2023 Accepting new patients
Rehab Specialists Outpatient, LLC Speech-Language Pathologist CurrentSince Jun 1, 2025 Accepting new patients

Locations

1010 NE Purcell Blvd
Bend, OR 97701
Phone (541) 318-6042

4560 SE International Way
Ste 100
Portland, OR 97222
Phone (971) 206-5129

1417 SE 107th Ave
Portland, OR 97216
Phone (503) 408-0404

9000 SW 91st Ave
Tigard, OR 97223
Phone (503) 445-4363

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523577600000",
    "number": "1457569717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 577",
            "city": "CONWAY",
            "state": "WA",
            "postal_code": "982380577",
            "telephone_number": "360-920-2549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 ELZORA ST",
            "city": "MILTON FREEWATER",
            "state": "OR",
            "postal_code": "978629454",
            "telephone_number": "541-938-3318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOREMAN",
        "first_name": "VIRGINIA",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2018-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL00003806",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "012876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milton Freewater, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.