Individual provider Active NPI

Natasha Marie Carmichael, CCC-A

  • Audiologist
  • Hillsboro, OR
National Provider Identifier
1497760904
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
22056 Issued in OR
Practice address
6355 NE Cornell Rd
Hillsboro, OR 97124-5434
Phone
(503) 346-0640
Fax
(503) 346-0645
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 22056 OR Primary

Addresses

Primary practice location

6355 NE Cornell Rd
Hillsboro, OR 97124-5434

Mailing address

6355 NE Cornell Rd
Hillsboro, OR 97124-5434
Phone (503) 346-0640

Other practice location 1

707 SW Gaines St
Portland, OR 97239-2901
Phone (800) 452-3563

Other identifiers 1

IdentifierTypeStateIssuer
226574MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040719001245 OR Practitioner - Qualified Audiologist 0648259986 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22056ORMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Sep 9, 2022 Accepting new patients
University Professional Services Current Accepting new patients
University Professional Services CurrentSince Sep 9, 2022 Accepting new patients
University Professional Services Past Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

6355 NE Cornell Rd
Hillsboro, OR 97124
Phone (503) 418-3376

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

707 SW Gaines St
Portland, OR 97239
Phone (503) 492-2709

Organizations & group practices 4

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1497760904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6355 NE CORNELL RD",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971245434",
            "telephone_number": "503-346-0640",
            "fax_number": "503-346-0645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6355 NE CORNELL RD",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971245434",
            "telephone_number": "503-346-0640",
            "fax_number": "503-346-0645"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "707 SW Gaines St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972392901",
            "country_code": "US",
            "telephone_number": "800-452-3563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARMICHAEL",
        "first_name": "NATASHA",
        "middle_name": "MARIE",
        "credential": "CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OR",
            "license": "22056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "226574",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.