Individual provider Active NPI

Amber L Vermeesch, PHD, MSN, FNP-C, RN

  • Family Nurse Practitioner
  • Portland, OR
National Provider Identifier
1689716995
Registry record updated Mar 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201403724NP-PP Issued in OR
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

Updated by the provider on Mar 24, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
4159477OtherTNBLUE CROSS
4176429OtherTNBLUE CROSS
33477221MedicaidTN
4159484OtherTNBLUE CROSS
RN0000152041OtherTNRN LICENSE
33477221OtherTNMEDICARE

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230113002131 NC Practitioner - Nurse Practitioner 4082711098 Reassigns benefits to 2 organizations

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
Physicians Eldercare PAGroup PAC ID 0648184705, 236 clinicians
Curana Health of North Carolina PLLCGroup PAC ID 1850774332, 274 clinicians

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

LicenseStateTypeSpecialty
12591TNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Curana Health of North Carolina PLLC CurrentSince Jan 16, 2023 Accepting new patients
Physicians Eldercare PA CurrentSince Jan 16, 2023 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

  • FHIR API: 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.

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

Verify at the official NPI Registry.