Individual provider Active NPI

Erin Jessica Anderson, PNP

  • Pediatric Nurse Practitioner
  • Portland, OR
National Provider Identifier
1669427787
Registry record updated Dec 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
200650108NP PNP-PP Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
CDW6
Portland, OR 97239-3011
Phone
(503) 494-4808
NPI assigned
May 24, 2006
Last updated
Dec 10, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X R1470781 MN
Pediatric Nurse Practitioner 363LP0200X 200650108NP PNP-PP OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
CDW6
Portland, OR 97239-3011

Mailing address

3181 SW Sam Jackson Park Rd
CDW6
Portland, OR 97239-3011

Other names 1

  • Erin Jessica Robinson Former name

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
I20070330000031 OR Practitioner - Nurse Practitioner 0143286575 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

875 Oak St SE
Suite 3040
Salem, OR 97301-3975
Phone (503) 494-4808

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200650108NP PNP-PPORMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Mar 30, 2016 Accepting new patients
University Professional Services Current Accepting new patients
University Professional Services CurrentSince Mar 30, 2016 Accepting new patients

Locations

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

10151 SE Sunnyside Rd
Ste 100
Clackamas, OR 97015
Phone (503) 659-0880

3181 SW Sam Jackson Park Rd
#6
Portland, OR 97239
Phone (503) 494-4122

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

875 Oak St SE
Salem, OR 97301
Phone (503) 561-5719

875 Oak St SE
Ste 3040
Salem, OR 97301
Phone (503) 494-4808

Interoperability endpoints

  • Direct secure messaging: eandersonnp3544@direct.ohsu.edu

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449705600000",
    "number": "1669427787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "CDW6",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "CDW6",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-4808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ERIN",
        "middle_name": "JESSICA",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2015-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "R1470781",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OR",
            "license": "200650108NP PNP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "ROBINSON",
            "middle_name": "JESSICA",
            "credential": "PNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.