Individual provider Active NPI

Misha Rae Caldwell, ARNP

  • Pediatric Nurse Practitioner
  • Astoria, OR
National Provider Identifier
1700190030
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
ARNP9191206 Issued in FL
Practice address
2158 Exchange St.
Suite #206/207
Astoria, OR 97103
Phone
(503) 325-7337
Fax
(503) 325-3706
NPI assigned
Jul 28, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X ARNP9191206 FL Primary

Addresses

Primary practice location

2158 Exchange St.
Suite #206/207
Astoria, OR 97103

Mailing address

2158 Exchange St.
Suite #206/207
Astoria, OR 97103
Phone (503) 325-7337

Other identifiers 1

IdentifierTypeStateIssuer
1700190030MedicaidFL

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
I20161028002103 OR Practitioner - Nurse Practitioner 8820376668 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9191206FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Lutheran Charities CurrentSince Oct 6, 2016 Accepting new patients
Columbia Lutheran Charities CurrentSince Oct 6, 2016 Accepting new patients
Columbia Lutheran Charities Past Accepting new patients
Columbia Lutheran Charities Past Accepting new patients

Locations

2158 Exchange St
Ste 206
Astoria, OR 97103
Phone (503) 325-4321

2111 Exchange St
Astoria, OR 97103
Phone (503) 325-4321

2265 Exchange St
Astoria, OR 97103
Phone (503) 338-4075

Interoperability endpoints

  • Direct secure messaging: mcaldwell@abp.opdirect.net

Organizations & group practices 4

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": "1280275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1700190030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2158 EXCHANGE ST.",
            "address_2": "SUITE #206/207",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "97103",
            "telephone_number": "503-325-7337",
            "fax_number": "503-325-3706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2158 EXCHANGE ST.",
            "address_2": "SUITE #206/207",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "97103",
            "telephone_number": "503-325-7337",
            "fax_number": "503-325-3706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDWELL",
        "first_name": "MISHA",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-28",
        "last_updated": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "ARNP9191206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700190030",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, OR

Sources for this page

Verify at the official NPI Registry.