Active NPI
Kimberly Dawn Payne, LMT
- Specialist
- Portland, OR
National Provider Identifier
1790754372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 8152
- Practice address
- 4475 SW Scholls Ferry Rd
Ste 201
Portland, OR 97225-1955 - Phone
- (503) 516-7938
- NPI assigned
- Mar 16, 2006
- Last updated
- Nov 20, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 8152 | OR | Primary |
Addresses
Primary practice location
4475 SW Scholls Ferry Rd
Ste 201
Portland, OR 97225-1955
Mailing address
4475 SW Scholls Ferry Rd
Ste 201
Portland, OR 97225-1955
Phone (503) 516-7938
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
| License | State | Type | Specialty |
|---|---|---|---|
| 8152 | OR | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 2 Frisky Dingos | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1227139200000",
"number": "1790754372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4475 SW SCHOLLS FERRY RD",
"address_2": "STE 201",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972251955",
"telephone_number": "503-516-7938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4475 SW SCHOLLS FERRY RD",
"address_2": "STE 201",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972251955",
"telephone_number": "503-516-7938"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAYNE",
"first_name": "KIMBERLY",
"middle_name": "DAWN",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-16",
"last_updated": "2008-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OR",
"license": "8152",
"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 Nov 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.