Laurissa Marie Champion, DMD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

D8555 Issued in OR

Practice address

2115 NE 42ND Ave
Portland, OR 97213-1321

Phone

(503) 954-1372

Fax

(503) 954-1392

NPI assigned

Oct 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221436800000",
    "number": "1568559003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 NE 42ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131321",
            "telephone_number": "503-954-1372",
            "fax_number": "503-954-1392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 NE 42ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131321",
            "telephone_number": "503-954-1372",
            "fax_number": "503-954-1392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPION",
        "first_name": "LAURISSA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2008-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OR",
            "license": "D8555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devyn Nicole Champagne, DC
• Shannon Champagne, LCSW
• Jennie Stover Champion, M.D.
• Joshua Champion, MD
• Lauren Meredith Champion, D.O.
• Lillian Jade Champion
• Matthew Champion, M.D.
• Nichole Champion
• Natasha Champney
• Lawrence Chan Jr., OD

• Periodontics in Portland, OR
• Providers in Portland, OR by specialty
• Periodontics in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.