Individual provider Active NPI

Diana Louise Smith, CNM, WHNP

  • Advanced Practice Midwife
  • Portland, OR
National Provider Identifier
1821372715
Registry record updated Mar 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
201350017NP Issued in OR
Practice address
9427 SW Barnes Rd
Suite 395
Portland, OR 97225-6652
Phone
(503) 216-2602
NPI assigned
Oct 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 630 NM
Advanced Practice Midwife 367A00000X 201350017NP OR Primary

Addresses

Primary practice location

9427 SW Barnes Rd
Suite 395
Portland, OR 97225-6652

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130308000468 OR Practitioner - Certified Nurse Midwife (CNM) 3779756820 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

1130 NW 22ND Ave
Suite 220
Portland, OR 97210-2969
Phone (503) 413-8988

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
21057CAMDClinical Neuropsychologist
201350017NPORMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Clinics LLC CurrentSince Feb 3, 2014 Accepting new patients
Silverton Health Current Accepting new patients
Silverton Health CurrentSince Mar 26, 2020 Accepting new patients
Silverton Health CurrentSince Mar 26, 2020 Accepting new patients
University Professional Services CurrentSince Dec 2, 2013 Accepting new patients
University Professional Services CurrentSince Dec 2, 2013 Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

2800 N Vancouver Ave
Portland, OR 97227
Phone (503) 413-4340

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

342 Fairview St
Silverton, OR 97381
Phone (503) 525-7660

Interoperability endpoints

  • Direct secure messaging: dsmith95964@direct.lhs.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1318291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362528000000",
    "number": "1821372715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494",
            "fax_number": "503-215-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9427 SW BARNES RD",
            "address_2": "SUITE 395",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256652",
            "telephone_number": "503-216-2602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DIANA",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "CNM, WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-11",
        "last_updated": "2013-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NM",
            "license": "630",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "OR",
            "license": "201350017NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.