Individual provider Active NPI

Glen C Ritchie, FNP

  • Family Nurse Practitioner
  • Portland, OR
National Provider Identifier
1477958569
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201705566NP-PP Issued in OR
Practice address
9135 SW Barnes Rd Ste 461
Portland, OR 97225-6643
Phone
(503) 216-1150
NPI assigned
Oct 31, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201705566NP-PP OR Primary
Family Nurse Practitioner 363LF0000X 95001634 CA

Addresses

Primary practice location

9135 SW Barnes Rd Ste 461
Portland, OR 97225-6643

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170824001018 OR Practitioner - Nurse Practitioner 4284959289 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5050 NE Hoyt St
Suite 315
Portland, OR 97213-2982
Phone (503) 215-8580

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95001634CAMDFamily Nurse Practitioner
201705566NP-PPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Jul 1, 2023 Accepting new patients
Vibra Physicians LLC CurrentSince Feb 2, 2020 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jul 1, 2023 Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Jul 1, 2023 Accepting new patients

Locations

5 E River Park Pl E
Ste 460
Fresno, CA 93720

5050 NE Hoyt St
Ste 615
Portland, OR 97213
Phone (503) 215-8580

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

10300 NE Hancock St
Portland, OR 97220
Phone (503) 257-5500

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

9135 SW Barnes Rd
Ste 461
Portland, OR 97225
Phone (503) 216-1150

5050 NE Hoyt St
Ste 315
Portland, OR 97213
Phone (503) 215-8580

Interoperability endpoints

  • Direct secure messaging: gritchie2902724@oc.providencedirect.org

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1414713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1477958569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9135 SW BARNES RD STE 461",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256643",
            "telephone_number": "503-216-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RITCHIE",
        "first_name": "GLEN",
        "middle_name": "C",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-31",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201705566NP-PP",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95001634",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.