Active NPI
Patricia A Parker, DMD
- Dentist
- Albany, OR
National Provider Identifier
1477623122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D6295
- Practice address
- 2225 Pacific Blvd SE
Suite 201
Albany, OR 97321-7907 - Phone
- (541) 928-4300
- Fax
- (541) 928-9958
- NPI assigned
- Nov 9, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D6295 | OR | Primary |
Addresses
Primary practice location
2225 Pacific Blvd SE
Suite 201
Albany, OR 97321-7907
Mailing address
6950 NE Campus Way
Hillsboro, OR 97124-5611
Phone (503) 952-2164
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 136903 | Other | OR | OREGON HEALTH PLAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150511002118 | OR | Order and Referring Only - Oral Surgery | 2163741265 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D6295 | OR | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432166400000",
"number": "1477623122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6950 NE CAMPUS WAY",
"city": "HILLSBORO",
"state": "OR",
"postal_code": "971245611",
"telephone_number": "503-952-2164",
"fax_number": "503-526-4418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2225 PACIFIC BLVD SE",
"address_2": "SUITE 201",
"city": "ALBANY",
"state": "OR",
"postal_code": "973217907",
"telephone_number": "541-928-4300",
"fax_number": "541-928-9958"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARKER",
"first_name": "PATRICIA",
"middle_name": "A",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-09",
"last_updated": "2015-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OR",
"license": "D6295",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OREGON HEALTH PLAN",
"identifier": "136903",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albany, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.