NPIMap

Organization Active NPI

Providence Elderplace

  • Assisted Living Facility
  • Portland, OR
National Provider Identifier
1750837597
Registry record updated Aug 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
201130602LPN Issued in OR
Legal business name
PROVIDENCE ELDERPLACE
Practice address
16430 NE Hoyt St
Portland, OR 97230
Phone
(503) 875-5172
NPI assigned
Aug 31, 2016
Organization subpart
Yes
Parent organization
PROVIDENCE HEALTH SYSTEMSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 31, 2016

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

Authorized official

Name
Lomingo M Andrews
Title
LPN
Phone
(503) 546-9292

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 201130602LPN OR Primary

Addresses

Primary practice location

16430 NE Hoyt St
Portland, OR 97230

Mailing address

16430 NE Hoyt St
Portland, OR 97230-5846
Phone (503) 875-5172

National Provider Directory

National Provider Directory
Part of
Providence Elderplace

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472601600000",
    "number": "1750837597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16430 NE HOYT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972305846",
            "telephone_number": "503-875-5172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16430 NE HOYT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97230",
            "telephone_number": "503-875-5172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE ELDERPLACE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROVIDENCE HEALTH SYSTEMS",
        "enumeration_date": "2016-08-31",
        "last_updated": "2016-08-31",
        "status": "A",
        "authorized_official_last_name": "ANDREWS",
        "authorized_official_first_name": "LOMINGO",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "LPN",
        "authorized_official_telephone_number": "503-546-9292"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OR",
            "license": "201130602LPN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.