Individual provider Active NPI

Dawn Alison O'Connor, F.N.P.

  • Family Nurse Practitioner
  • Salem, OR
National Provider Identifier
1730295791
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
514577 Issued in CA
Practice address
925 Commercial St SE Ste 102
Salem, OR 97302-4173
Phone
(541) 758-0766
Fax
(541) 753-2737
NPI assigned
Aug 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 514577 CA Primary

Addresses

Primary practice location

925 Commercial St SE Ste 102
Salem, OR 97302-4173

Mailing address

981 NW Spruce Ave
Corvallis, OR 97330-2111
Phone (541) 758-0766

Other names 1

  • Mrs. Dawn Alison Liddell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, OR2 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

Enrollment IDStateProvider typePAC IDDetails
I20120105000260 CA Practitioner - Nurse Practitioner 4486820990 Reassigns benefits to 1 organization
I20200225000784 OR Practitioner - Nurse Practitioner 4486820990 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley ClinicsGroup PAC ID 4981943776, 13 clinicians

Practice addresses (Care Compare)

3388 Pacific Blvd SW
Albany, OR 97321-7707
Phone (541) 758-0766

981 NW Spruce Ave
Corvallis, OR 97330-2111
Phone (541) 758-0766

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc CurrentSince Nov 12, 2011 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Nov 11, 2019 Accepting new patients
Valley Clinics CurrentSince Jan 1, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Nov 11, 2019 Accepting new patients
Permanente Medical Group Inc Current Accepting new patients
Permanente Medical Group, Inc CurrentSince Nov 12, 2011 Accepting new patients
Corvallis Internal Medicine, PC PastSince Mar 12, 2015 Accepting new patients

Locations

1800 Harrison St
Fl 7
Oakland, CA 94612

3900 Lakeville Hwy
Petaluma, CA 94954
Phone (707) 765-3594

99 Montecillo Rd
San Rafael, CA 94903
Phone (415) 444-2047

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

3388 Pacific Blvd SW
Albany, OR 97321
Phone (541) 758-0766

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

981 NW Spruce Ave
Corvallis, OR 97330
Phone (541) 758-0766

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

350 Miller St SE
Salem, OR 97302
Phone (503) 370-8784

925 Commercial St SE
Ste 102
Salem, OR 97302
Phone (503) 990-7187

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

Organizations & group practices 7

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1730295791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "981 NW SPRUCE AVE",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973302111",
            "telephone_number": "541-758-0766",
            "fax_number": "541-753-2737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 COMMERCIAL ST SE STE 102",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024173",
            "telephone_number": "541-758-0766",
            "fax_number": "541-753-2737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "DAWN",
        "middle_name": "ALISON",
        "name_prefix": "Ms.",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2024-04-19",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "514577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAWN",
            "last_name": "LIDDELL",
            "middle_name": "ALISON",
            "prefix": "MRS.",
            "credential": "F.N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.