Individual provider Active NPI

Lisa Lee Rohm, NP

  • Family Nurse Practitioner
  • Port Orford, OR
National Provider Identifier
1487274361
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10008819APRN-NP Issued in OR
Practice address
525 Madrona Ave
Port Orford, OR 97465-9552
Phone
(541) 332-3281
Fax
(541) 332-0250
NPI assigned
Apr 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 10008819APRN-NP OR Primary

Addresses

Primary practice location

525 Madrona Ave
Port Orford, OR 97465-9552

Mailing address

40551 Little River Airport Rd
Little River, CA 95456-9665
Phone (503) 708-8182

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, WV, OR3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20210323000832 CA Practitioner - Nurse Practitioner 5890102685
I20220421001787 WV Practitioner - Nurse Practitioner 5890102685 Reassigns benefits to 1 organization
I20231222002741 OR Practitioner - Nurse Practitioner 5890102685 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10008819APRN-NPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Surprise Valley Health Care District Current Accepting new patients
Webster Memorial Hospital, Inc. CurrentSince Mar 1, 2022 Accepting new patients
Curry Health District CurrentSince Feb 1, 2024 Accepting new patients
Curry Health District CurrentSince Feb 1, 2024 Accepting new patients
Curry Health District Past Accepting new patients

Locations

500 5th St
Brookings, OR 97415
Phone (541) 412-2000

94220 4th St
Gold Beach, OR 97444
Phone (541) 247-3000

125 Diana Dr
Webster Springs, WV 26288
Phone (304) 847-5682

Interoperability endpoints

  • Direct secure messaging: lrohm3366622@oc.providencedirect.org

Organizations & group practices 5

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": "1587427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1487274361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40551 LITTLE RIVER AIRPORT RD",
            "city": "LITTLE RIVER",
            "state": "CA",
            "postal_code": "954569665",
            "telephone_number": "503-708-8182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 MADRONA AVE",
            "city": "PORT ORFORD",
            "state": "OR",
            "postal_code": "974659552",
            "telephone_number": "541-332-3281",
            "fax_number": "541-332-0250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROHM",
        "first_name": "LISA",
        "middle_name": "LEE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-21",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "10008819APRN-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orford, OR

Sources for this page

Verify at the official NPI Registry.