Individual provider Active NPI

Elizabeth Nierman, LMT

  • Specialist
  • Bend, OR
National Provider Identifier
1780045450
Registry record updated Mar 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
20836 Issued in OR
Practice address
1364 NW Davenport Ave
Bend, OR 97703-3077
Phone
(541) 410-0909
NPI assigned
Mar 9, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 20836 OR
Specialist 174400000X 20836 OR Primary

Addresses

Primary practice location

1364 NW Davenport Ave
Bend, OR 97703-3077

Mailing address

1364 NW Davenport Ave
Bend, OR 97703-3077
Phone (541) 410-0909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
20836ORMDContractor

NPI Registry JSON

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

{
    "created_epoch": "1457481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457481600000",
    "number": "1780045450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1364 NW DAVENPORT AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977033077",
            "telephone_number": "541-410-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1364 NW DAVENPORT AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977033077",
            "telephone_number": "541-410-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIERMAN",
        "first_name": "ELIZABETH",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-09",
        "last_updated": "2016-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "OR",
            "license": "20836",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "20836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.