Active NPI
Breanna Davis, CNM, WHNP
- Advanced Practice Midwife
- Bend, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- 10006160
- Practice address
- 2500 NE Neff Rd
Bend, OR 97701-6015 - Phone
- (541) 382-4321
- NPI assigned
- Aug 27, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Advanced Practice Midwife | 367A00000X | PENDING | CA | |
| Advanced Practice Midwife | 367A00000X | 10006160 | OR | Primary |
Addresses
Primary practice location
2500 NE Neff Rd
Bend, OR 97701-6015
Mailing address
PO Box 6095
Bend, OR 97708-6095
Phone (541) 706-5922
Other practice location 1
24411 Health Center Dr Ste 200
Laguna Hills, CA 92653-3633
Phone (949) 829-5500
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | bdavis177957@secure.stcharleshealthcare.org |
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230530000516 | OR | Practitioner - Certified Nurse Midwife (CNM) | 1254798713 | Reassigns benefits to 2 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PENDING | CA | MD | Dentist |
| 10006160 | OR | MD | Advanced Practice Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Charles Health System, Inc. | Current | Accepting new patients | |
| St. Charles Health System, Inc. | Current | Accepting new patients | |
| St. Charles Health System, Inc. | Current | Accepting new patients | |
| St. Charles Health System, Inc. | Current | Accepting new patients | |
| St. Charles Health System, Inc. | Current | Accepting new patients | |
| St. Charles Health System, Inc. | Past | Accepting new patients |
Locations
29358 Network Pl
Chicago, IL 60673
1345 NW Wall St
Ste 200
Bend, OR 97703
Phone (541) 330-2103
2500 NE Neff Rd
Bend, OR 97701
Phone (541) 388-4333
1253 NW Canal Blvd
Redmond, OR 97756
Phone (541) 548-8131
340 NW 5th St
Ste 101
Redmond, OR 97756
Phone (734) 545-3348
211 NW Larch Ave
Redmond, OR 97756
Phone (541) 548-2164
Organizations & group practices 6
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.
-
- Rehabilitation Hospital Unit
- Bend, OR
- NPI 1154343150
-
- Specialist
- Bend, OR
- NPI 1700697935
-
- Clinical Social Worker
- Bend, OR
- NPI 1780698696
-
- Oxygen Equipment & Supplies (DME)
- Redmond, OR
- NPI 1427140870
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690934400000",
"number": "1649828286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6095",
"city": "BEND",
"state": "OR",
"postal_code": "977086095",
"telephone_number": "541-706-5922",
"fax_number": "541-706-6869"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 NE NEFF RD",
"city": "BEND",
"state": "OR",
"postal_code": "977016015",
"telephone_number": "541-382-4321"
}
],
"practiceLocations": [
{
"address_1": "24411 Health Center Dr Ste 200",
"address_purpose": "LOCATION",
"city": "Laguna Hills",
"state": "CA",
"postal_code": "926533633",
"country_code": "US",
"telephone_number": "949-829-5500",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVIS",
"first_name": "BREANNA",
"credential": "CNM, WHNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-27",
"last_updated": "2023-08-02",
"certification_date": "2023-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "CA",
"license": "PENDING",
"primary": false
},
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "OR",
"license": "10006160",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "bdavis177957@secure.stcharleshealthcare.org",
"affiliation": "N",
"address_1": "2500 NE Neff Rd",
"city": "Bend",
"state": "OR",
"country_code": "US",
"postal_code": "977016015",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; 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.