Callie Chere' Peters, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA201744 Issued in OR

Practice address

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

Phone

(503) 494-4314

Fax

(503) 346-6810

NPI assigned

Oct 13, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Callie Chere' Munson Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR, WA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Uptown Providers PCGroup PAC ID 4284891243, 43 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Uptown Providers PC

  • Urgent Care Clinic/Center
  • Vancouver, WA
  • NPI 1255102034
  Medicare reassignment Care Compare group NPD
• Uptown Providers PC

  • Urgent Care Clinic/Center
  • Tigard, OR
  • NPI 1346903531
  Medicare reassignment
• Uptown Providers Inc

  • Urgent Care Clinic/Center
  • Portland, OR
  • NPI 1134563620
  NPD
• Uptown Providers PC

  • Urgent Care Clinic/Center
  • Vancouver, WA
  • NPI 1912702465
  NPD
• Uptown Providers PC

  • General Practice Physician
  • Portland, OR
  • NPI 1144598293
  NPD (past)

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

{
    "created_epoch": "1602547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1699373530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 SW 5TH AVE STE 500",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972015537",
            "telephone_number": "866-617-6855",
            "fax_number": "503-346-8015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-4314",
            "fax_number": "503-346-6810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4400 NE Halsey St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972131545",
            "country_code": "US",
            "telephone_number": "503-962-1000",
            "fax_number": "503-963-3140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERS",
        "first_name": "CALLIE",
        "middle_name": "CHERE'",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-13",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA201744",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA201744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500785527",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "referringpulm@orclinic.direct-ci.net",
            "affiliation": "Y",
            "affiliationName": "Oregon Clinic PC",
            "address_1": "1111 NE 99th Ave Ste 200",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972209442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CALLIE",
            "last_name": "MUNSON",
            "middle_name": "CHERE'",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Diana Peterman-St Amour
• Alicia Renee Peterman, ND
• Austin Peters, M.D.
• Bianca I Peters, DO
• Blair Peters
• Casey Lynne Peters
• Elizabeth Peters, MA, CCC-SLP
• Grace Elizabeth Peters, L.AC.
• Ian Peters
• Janae Peters

• Surgical Physician Assistant in Portland, OR
• Providers in Portland, OR by specialty
• Surgical Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; 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.

Verify at the official NPI Registry.