Individual provider Active NPI

Carrie A. Scheckla, NNP

  • Neonatal Nurse Practitioner
  • Portland, OR
National Provider Identifier
1912146549
Registry record updated Feb 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
20065046NP Issued in OR
Practice address
2801 N Gantenbein Ave
Nicu
Portland, OR 97227-1623
Phone
(503) 413-4507
Fax
(503) 413-2580
NPI assigned
Feb 4, 2009
Last updated
Feb 4, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 20065046NP OR Primary

Addresses

Primary practice location

2801 N Gantenbein Ave
Nicu
Portland, OR 97227-1623

Mailing address

2801 N Gantenbein Ave
Nicu
Portland, OR 97227-1623
Phone (503) 413-4507

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110726000847 OR Practitioner - Nurse Practitioner 6800064494 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
20065046NPORMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Health CurrentSince Apr 14, 2011 Accepting new patients
Salem Health CurrentSince Apr 14, 2011 Accepting new patients

Locations

1049 Edgewater St NW
#150
Salem, OR 97304
Phone (503) 814-3343

665 Winter St SE
Salem, OR 97301
Phone (503) 370-5634

Organizations & group practices 2

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": "1233705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233705600000",
    "number": "1912146549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 N GANTENBEIN AVE",
            "address_2": "NICU",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271623",
            "telephone_number": "503-413-4507",
            "fax_number": "503-413-2580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 N GANTENBEIN AVE",
            "address_2": "NICU",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271623",
            "telephone_number": "503-413-4507",
            "fax_number": "503-413-2580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHECKLA",
        "first_name": "CARRIE",
        "middle_name": "A.",
        "credential": "NNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-04",
        "last_updated": "2009-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "OR",
            "license": "20065046NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.