Active NPI
James Peterson, CRNA
- Certified Registered Nurse Anesthetist
- Clackamas, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 200660029CRNA
- Practice address
- 10180 SE Sunnyside Rd
Clackamas, OR 97015-8970 - Phone
- (503) 652-2880
- NPI assigned
- Sep 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 200660029CRNA | OR | Primary |
Addresses
Primary practice location
10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Mailing address
10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) | Northwest Permanente PC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR, WA
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2211 NE 139TH St
Vancouver, WA 98686-2742
Phone (360) 487-1000
9701 SW Barnes Rd
Suite 300
Portland, OR 97225-6689
Phone (503) 297-8081
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200660029CRNA | OR | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Northwest | Current | Accepting new patients | |
| Metropolitan Anesthesia LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Complete Anesthesia Care LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Oregon Anesthesiology Group PC | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Northwest | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Northwest | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
10180 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2880
10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946
9701 SW Barnes Rd
Ste 300
Portland, OR 97225
Phone (503) 297-8081
1130 NW 22nd Ave
Ste 615
Portland, OR 97210
Phone (503) 229-7137
700 NE Multnomah St
Ste 1650
Portland, OR 97232
Phone (503) 734-1850
707 SW Washington St
Ste 700
Portland, OR 97205
1130 NW 22nd Ave
Ste 410
Portland, OR 97210
Phone (503) 229-7137
2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400
2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985
Organizations & group practices 6
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.
-
- Anesthesiology Physician
- Portland, OR
- NPI 1720387954
Nurse Anesthetist, Certified Registered
-
- Certified Registered Nurse Anesthetist
- Portland, OR
- NPI 1932464492
Nurse Anesthetist, Certified Registered
-
- General Practice Physician
- Portland, OR
- NPI 1184786527
Nurse Anesthetist, Certified Registered
-
dba Interstate Radiation Oncology
- Radiation Oncology Clinic/Center
- Portland, OR
- NPI 1093043424
-
- Clinic/Center
- Hillsboro, OR
- NPI 1942718622
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Legacy Salmon Creek Providers
- Clinic/Center
- Vancouver, WA
- NPI 1356357784
Hospital
-
- General Acute Care Hospital
- Vancouver, WA
- NPI 1700809829
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643932800000",
"number": "1730281502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10180 SE SUNNYSIDE RD",
"city": "CLACKAMAS",
"state": "OR",
"postal_code": "970158970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10180 SE SUNNYSIDE RD",
"city": "CLACKAMAS",
"state": "OR",
"postal_code": "970158970",
"telephone_number": "503-652-2880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "JAMES",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-02",
"last_updated": "2022-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "OR",
"license": "200660029CRNA",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Northwest Permanente PC",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "10180 SE Sunnyside Rd",
"city": "Clackamas",
"state": "OR",
"country_code": "US",
"postal_code": "970158970",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Clackamas, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.