NPIMap

Individual provider Active NPI

Audra Luz Kathleena Wisham, M.D.

  • Emergency Medicine Physician
  • Newport, OR
National Provider Identifier
1477961308
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD182496 Issued in OR
Practice address
930 SW Abbey St
Newport, OR 97365-4820
Phone
(541) 265-2244
Fax
(541) 574-1838
NPI assigned
Jul 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD182496 OR Primary

Addresses

Primary practice location

930 SW Abbey St
Newport, OR 97365-4820

Mailing address

PO Box 2847
Corvallis, OR 97339-2847

Other identifiers 1

IdentifierTypeStateIssuer
500729523MedicaidOR

Other names 1

  • Dr. Audra Luz Kathleena Almeyda Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address awisham136647@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, GA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170829004166 OR Practitioner - Emergency Medicine 3375816150 Reassigns benefits to 8 organizations
I20230728002595 GA Practitioner - Emergency Medicine 3375816150 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Loma Linda University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Confederated Tribes of SiletzGroup PAC ID 6204729288, 12 clinicians
Samaritan North Lincoln HospitalGroup PAC ID 7911816301, 42 clinicians

Practice addresses (Care Compare)

200 Gwee Shut Rd
Siletz, OR 97380-2036
Phone (541) 444-1030

3043 NE 28TH St
Lincoln City, OR 97367-4518
Phone (541) 994-3661

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.65 of 100Reported as group
Quality
86.8
Promoting interoperability
100
Improvement activities
40
Cost
86.36

Merit-based Incentive Payment System (MIPS)

Final score
93.21 of 100Reported as group
Quality
84.26
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
92.23
Promoting interoperability
100
Improvement activities
40
Cost
100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD182496ORMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan North Lincoln Hospital CurrentSince Feb 18, 2018 Accepting new patients
Confederated Tribes of Siletz CurrentSince Sep 8, 2025 Accepting new patients
Samaritan North Lincoln Hospital CurrentSince Dec 22, 2025 Accepting new patients
Confederated Tribes of Siletz CurrentSince Sep 8, 2025 Accepting new patients
Samaritan Pacific Health Services, Inc. Current Accepting new patients
Samaritan Pacific Health Services, Inc. CurrentSince Jul 25, 2017 Accepting new patients
Northwest Emergency Physicians LLC Emergency Medicine CurrentSince Jul 1, 2021 Accepting new patients
Samaritan Pacific Health Services, Inc CurrentSince Jul 25, 2017 Accepting new patients
Samaritan North Lincoln Hospital CurrentSince Feb 18, 2018 Accepting new patients
Samaritan Pacific Health Services, Inc Current Accepting new patients
Montgomery Emergency Group, LLC Emergency Medicine CurrentSince Jun 14, 2023 Accepting new patients

Locations

1 Meadows Pkwy
Vidalia, GA 30474
Phone (912) 535-5429

1046 6th Ave SW
Albany, OR 97321
Phone (541) 812-4000

777 NW 9th St
Ste 102
Corvallis, OR 97330
Phone (541) 768-6769

3043 NE 28th St
Lincoln City, OR 97367
Phone (541) 994-3661

930 SW Abbey St
Newport, OR 97365
Phone (541) 265-2244

Interoperability endpoints

  • Direct secure messaging: audra.wisham.p1@direct.siletzhealthclinic.nextgenshare.com

Organizations & group practices 12

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 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1406073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1477961308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2847",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973392847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 SW ABBEY ST",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973654820",
            "telephone_number": "541-265-2244",
            "fax_number": "541-574-1838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISHAM",
        "first_name": "AUDRA LUZ",
        "middle_name": "KATHLEENA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-23",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD182496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500729523",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "awisham136647@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "930 SW Abbey St",
            "city": "Newport",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973654820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AUDRA LUZ",
            "last_name": "ALMEYDA",
            "middle_name": "KATHLEENA",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Newport, OR

Sources for this page

Verify at the official NPI Registry.