Active NPI
Kate Hanna Blumner, MD
- Psychiatry Physician
- Portland, OR
National Provider Identifier
1780740548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD125905
- Practice address
- 1600 SE Bybee Blvd
Suite 200
Portland, OR 97202-5759 - Phone
- (971) 229-0269
- Fax
- (971) 229-0617
- NPI assigned
- Dec 28, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD125905 | OR | Primary |
| Psychiatry Physician | 2084P0800X | MD432129 | PA |
Addresses
Primary practice location
1600 SE Bybee Blvd
Suite 200
Portland, OR 97202-5759
Mailing address
1600 SE Bybee Blvd
Suite 200
Portland, OR 97202-5759
Phone (971) 229-0269
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500622221 | Medicaid | OR | |
| 500626731 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jun 29, 2022 through Jun 29, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD432129 | PA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423180800000",
"number": "1780740548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 SE BYBEE BLVD",
"address_2": "SUITE 200",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972025759",
"telephone_number": "971-229-0269",
"fax_number": "971-229-0617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 SE BYBEE BLVD",
"address_2": "SUITE 200",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972025759",
"telephone_number": "971-229-0269",
"fax_number": "971-229-0617"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLUMNER",
"first_name": "KATE",
"middle_name": "HANNA",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-28",
"last_updated": "2015-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "OR",
"license": "MD125905",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "MD432129",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500622221",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500626731",
"state": "OR"
}
],
"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 Feb 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.