Roberta Carolyn Bentson-Royal, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

200050055NP Issued in OR

Practice address

426 SW Stark St
8TH Floor
Portland, OR 97204-2347

Phone

(503) 988-3674

Fax

(503) 988-3676

NPI assigned

Jan 19, 2007

Last updated

Feb 5, 2021By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Interoperability endpoints

• Direct secure messaging: rbentsonroyal1169283@oc.providencedirect.org

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1679626964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 SW STARK ST",
            "address_2": "8TH FLOOR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972042347",
            "telephone_number": "503-988-3674",
            "fax_number": "503-988-3676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 SW STARK ST",
            "address_2": "8TH FLOOR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972042347",
            "telephone_number": "503-988-3674",
            "fax_number": "503-988-3676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENTSON-ROYAL",
        "first_name": "ROBERTA",
        "middle_name": "CAROLYN",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OR",
            "license": "200050055NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rbentsonroyal1169283@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "830 NE 47th Ave",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nancy Ann Benton, RN, CNS
• Regenia Gail Benton, L.AC.
• Sydney Benton, LAC
• Sydney Josephine Benton, QMHA
• Troy Benton, L.M.T.
• Charles Joseph Bentz, MD
• Kelly Bentz
• Sean Robert Benvenuti, QMHA
• Jamie Benz
• Ashley Wollscheid Benza, RBAI, RBT

• Pediatric Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Pediatric Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.