Individual provider Active NPI

Whitney Renee Ault, NP-C

  • Family Nurse Practitioner
  • Portland, OR
National Provider Identifier
1649674961
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201405789NP-PP Issued in OR
Practice address
2735 NE 82ND Ave
Portland, OR 97220-5304
Phone
(503) 988-3382
NPI assigned
Oct 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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 201405789NP-PP OR Primary

Addresses

Primary practice location

2735 NE 82ND Ave
Portland, OR 97220-5304

Mailing address

619 NW 6TH Ave FL 5
Portland, OR 97209-3964
Phone (503) 988-7468

Other practice location 1

5840 NE 50th Ave
Portland, OR 97218-1879
Phone (505) 270-3415

Other practice location 2

5311 N Vancouver Ave
Portland, OR 97217-2731
Phone (503) 281-0308

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141110001224 OR Practitioner - Nurse Practitioner 2062634983 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Multnomah County CurrentSince Oct 10, 2023 Accepting new patients
Multnomah County CurrentSince Oct 10, 2023 Accepting new patients
Multnomah County Current Accepting new patients
Multnomah County PastSince Nov 5, 2023 Accepting new patients

Locations

600 NE 8th St
Gresham, OR 97030
Phone (503) 988-4900

209 SW 4th Ave
Ste 210
Portland, OR 97204
Phone (503) 988-3674

619 NW 6th Ave
Fl 5
Portland, OR 97209
Phone (503) 988-3674

619 NW 6th Ave
Portland, OR 97209
Phone (503) 988-3674

Interoperability endpoints

  • Direct secure messaging: wault669910@direct.ochin.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": "1413331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1649674961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 NW 6TH AVE FL 5",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093964",
            "telephone_number": "503-988-7468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2735 NE 82ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972205304",
            "telephone_number": "503-988-3382"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5840 NE 50th Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972181879",
            "country_code": "US",
            "telephone_number": "505-270-3415",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5311 N Vancouver Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972172731",
            "country_code": "US",
            "telephone_number": "503-281-0308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AULT",
        "first_name": "WHITNEY",
        "middle_name": "RENEE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-15",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201405789NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.