NPIMap

Individual provider Active NPI

Robert Allen Sperry, PMNHP

  • Psychiatric/Mental Health Nurse Practitioner
  • Seaside, OR
National Provider Identifier
1487831368
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
201350052NP Issued in OR
Practice address
725 S Wahanna Rd
Seaside, OR 97138-7735
Phone
(503) 717-7000
Fax
(503) 717-7476
NPI assigned
Jan 23, 2008
Last updated
Sep 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP-09069 OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 201350052NP OR Primary

Addresses

Primary practice location

725 S Wahanna Rd
Seaside, OR 97138-7735

Mailing address

PO Box 3397
Portland, OR 97208-3397

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rsperry388547@oc.providencedirect.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140321000075 OR Practitioner - Nurse Practitioner 6406932334 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia Lutheran CharitiesGroup PAC ID 5294643359, shared by 8 NPIs, 110 clinicians

Practice addresses (Care Compare)

1905 Exchange St
Astoria, OR 97103
Phone (503) 338-4085

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP-09069OHMDPsychiatric/Mental Health Nurse Practitioner
201350052NPORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Lutheran Charities CurrentSince May 1, 2022 Accepting new patients
Columbia Lutheran Charities Current Accepting new patients
Columbia Lutheran Charities CurrentSince May 1, 2022 Accepting new patients
Columbia Lutheran Charities Past Accepting new patients
Psychiatric Professional Services Psychiatric/Mental Health Past Accepting new patients
Northern Kentucky Mental Health Mental Retardation Regional Board Past Accepting new patients
Columbia Lutheran Charities Past Accepting new patients

Locations

2111 Exchange St
Astoria, OR 97103
Phone (503) 325-4321

2158 Exchange St
Ste 107
Astoria, OR 97103
Phone (503) 338-4675

1111 N Roosevelt Dr
Ste 210
Seaside, OR 97138
Phone (503) 738-3002

Interoperability endpoints

  • Direct secure messaging: rsperry388547@oc.providencedirect.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1201046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1487831368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3397",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S WAHANNA RD",
            "city": "SEASIDE",
            "state": "OR",
            "postal_code": "971387735",
            "telephone_number": "503-717-7000",
            "fax_number": "503-717-7476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPERRY",
        "first_name": "ROBERT",
        "middle_name": "ALLEN",
        "credential": "PMNHP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-23",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "NP-09069",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201350052NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rsperry388547@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "727 S Wahanna Rd Ste 210",
            "city": "Seaside",
            "state": "OR",
            "country_code": "US",
            "postal_code": "971387735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seaside, OR

Sources for this page

Verify at the official NPI Registry.