Active NPI
Amber L Vermeesch, PHD, MSN, FNP-C, RN
- Family Nurse Practitioner
- Portland, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 201403724NP-PP
- Practice address
- 4400 NE Halsey St
BLDG 2, Suite 400
Portland, OR 97213-1545 - Phone
- (425) 525-3395
- NPI assigned
- Feb 13, 2007
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704285068 | MI | |
| Family Nurse Practitioner | 363LF0000X | 201403724NP-PP | OR | Primary |
Addresses
Primary practice location
4400 NE Halsey St
BLDG 2, Suite 400
Portland, OR 97213-1545
Mailing address
4400 NE Halsey St.
BLDG 2, Suite 400
Portland, OR 97213
Phone (425) 525-3395
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4159477 | Other | TN | BLUE CROSS |
| 4176429 | Other | TN | BLUE CROSS |
| 33477221 | Medicaid | TN | |
| 4159484 | Other | TN | BLUE CROSS |
| RN0000152041 | Other | TN | RN LICENSE |
| 33477221 | Other | TN | MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4692 Brownsboro Rd
Winston Salem, NC 27106-3410
Phone (336) 251-1114
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science - Nursing, Nurse Practitioner, Doctor of Philosophy, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12591 | TN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Curana Health of North Carolina PLLC | Current | Accepting new patients | |
| Physicians Eldercare PA | Current | Accepting new patients | |
| Children and Adults Medical Group, LLC | Past | Accepting new patients |
Locations
1509 Dulles Dr
Lafayette, LA 70506
Phone (337) 408-0803
5306 NC Highway 55
Ste 105
Durham, NC 27713
Phone (919) 457-1517
4692 Brownsboro Rd
Winston Salem, NC 27106
Phone (336) 251-1114
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Durham, NC
- NPI 1770217176
-
- General Practice Physician
- Durham, NC
- NPI 1023083268
-
- Multi-Specialty Clinic/Center
- Nashville, TN
- NPI 1659487494
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490313600000",
"number": "1689716995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4400 NE HALSEY ST.",
"address_2": "BLDG 2, SUITE 400",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97213",
"telephone_number": "425-525-3395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4400 NE HALSEY ST",
"address_2": "BLDG 2, SUITE 400",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972131545",
"telephone_number": "425-525-3395"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERMEESCH",
"first_name": "AMBER",
"middle_name": "L",
"credential": "PHD, MSN, FNP-C, RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-13",
"last_updated": "2017-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704285068",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OR",
"license": "201403724NP-PP",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "4159477",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "4176429",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "33477221",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "4159484",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN LICENSE",
"identifier": "RN0000152041",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "33477221",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2017; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.