Individual provider Active NPI

Bette Gay Seagren, FNP

  • Primary Care Nurse Practitioner
  • Canby, OR
National Provider Identifier
1790969491
Registry record updated Oct 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
000037573N1 Issued in OR
Practice address
143 NW 4TH Ave
Canby, OR 97013-3101
Phone
(503) 263-6611
Fax
(503) 266-5674
NPI assigned
Dec 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 000037573N1 OR Primary

Addresses

Primary practice location

143 NW 4TH Ave
Canby, OR 97013-3101

Mailing address

143 NW 4TH Ave
Canby, OR 97013-3101
Phone (503) 263-6611

Other identifiers 1

IdentifierTypeStateIssuer
282467MedicaidOR

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)
Enrolled
Credentials
Nurse Practitioner

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23575/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287964800000",
    "number": "1790969491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 NW 4TH AVE",
            "city": "CANBY",
            "state": "OR",
            "postal_code": "970133101",
            "telephone_number": "503-263-6611",
            "fax_number": "503-266-5674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 NW 4TH AVE",
            "city": "CANBY",
            "state": "OR",
            "postal_code": "970133101",
            "telephone_number": "503-263-6611",
            "fax_number": "503-266-5674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEAGREN",
        "first_name": "BETTE",
        "middle_name": "GAY",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-18",
        "last_updated": "2010-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OR",
            "license": "000037573N1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "282467",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canby, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2010; 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.