Ila Airy-Sunny Kipilman, CRM

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

1312 SW Washington St
Portland, OR 97205-2327

Phone

(503) 535-1186

NPI assigned

Apr 16, 2021

Last updated

Apr 16, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1618531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1881275329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4311 SE 79TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972063308",
            "telephone_number": "503-702-6467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 SW WASHINGTON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052327",
            "telephone_number": "503-535-1186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIPILMAN",
        "first_name": "ILA",
        "middle_name": "AIRY-SUNNY",
        "credential": "CRM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-16",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ila.kipilman@depaultc.org",
            "affiliation": "N",
            "endpointDescription": "Professional Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Electronic mail",
            "address_1": "1312 SW Washington St",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972052327",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• John David Kinzie, MD
• John Mark Kinzie, MD
• Luke Kinzie, RN
• Phoebe Kioschos
• Kip Williams Psychotherapy (a Marriage & Family Therapy Corporation)
• Alissa K Kipp, LMT
• Matthew David Kipp, PHARMD
• David Kirakossian, M.D.
• Laszlo Nicholas Kiraly, M.D.
• Kiran Mistry, DDS, PC

• Peer Specialist in Portland, OR
• Providers in Portland, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; 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.