NPIMap

Organization Active NPI

University Professional Services

Doing business as University Professional Services PLC-011

  • General Practice Physician
  • Salem, OR
National Provider Identifier
1780823823
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
UNIVERSITY PROFESSIONAL SERVICES
Doing business as
University Professional Services PLC-011
Practice address
875 Oak St SE
Salem, OR 97301-3975
Phone
(503) 418-5150
Fax
(503) 346-6854
NPI assigned
Feb 12, 2009
Last updated
Sep 12, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
UNIVERSITY PROFESSIONAL SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Authorized official

Name
Kelly Anne Smith
Title
VP/Enterprise Revenue Cycle
Phone
(503) 494-4422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

875 Oak St SE
Salem, OR 97301-3975

Mailing address

1400 SW 5TH Ave FL 5
Portland, OR 97201-5509
Phone (866) 617-6855

Other identifiers 1

IdentifierTypeStateIssuer
500605335MedicaidOR

Other names 1

  • University Professional Services PLC-011 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080910000013 OR Part B Supplier - Clinic/Group Practice 4880760107 Receives reassigned benefits from 2,434 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
University Professional Services

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1234396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757635200000",
    "number": "1780823823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 SW 5TH AVE FL 5",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972015509",
            "telephone_number": "866-617-6855",
            "fax_number": "503-346-8015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 OAK ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013975",
            "telephone_number": "503-418-5150",
            "fax_number": "503-346-6854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY PROFESSIONAL SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY PROFESSIONAL SERVICES",
        "enumeration_date": "2009-02-12",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "VP/ENTERPRISE REVENUE CYCLE",
        "authorized_official_telephone_number": "503-494-4422"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500605335",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Professional Services PLC-011",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.