NPIMap

Individual provider Active NPI

Annalisa Colleen Hawthorne, D.O.

  • Family Medicine Physician
  • Newberg, OR
National Provider Identifier
1922445394
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO172429 Issued in OR
Practice address
1000 N Providence Dr Ste 210
Newberg, OR 97132-7582
Phone
(503) 537-5900
NPI assigned
May 26, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO172429 OR Primary

Addresses

Primary practice location

1000 N Providence Dr Ste 210
Newberg, OR 97132-7582

Mailing address

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

Other practice location 1

1002 N Boones Ferry Rd
Woodburn, OR 97071-9602
Phone (503) 981-9602

Other names 1

  • Annalisa Coleen Wood Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ahawthorne945487@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160701001773 OR Practitioner - Family Practice 3476784356 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Arizona College of Osteopathic Medicine Mid Western University, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services Oregon 1,423 clinicians

Practice addresses (Care Compare)

29345 SW Town Ctr Loop E
Suite 110
Wilsonville, OR 97070-8486
Phone (503) 582-2100

Hospital & facility affiliations

  • Providence Newberg Medical Center Hospital, Newberg, OR, CCN 380037
  • Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004
  • Providence Willamette Falls Medical Center Hospital, Oregon City, OR, CCN 380038
  • Providence Portland Medical Center Hospital, Portland, OR, CCN 380061

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
6986NEMDMental Health Counselor
DO172429ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Family Medicine CurrentSince Aug 1, 2018 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Legacy Clinics LLC Family Medicine CurrentSince Nov 13, 2016 Accepting new patients
Providence Health & Services - Oregon CurrentSince Aug 1, 2018 Accepting new patients
Providence Health & Services Oregon CurrentSince Aug 1, 2018 Accepting new patients
Legacy Clinics LLC CurrentSince Nov 13, 2016 Accepting new patients
Providence Health & Services - Oregon CurrentSince Aug 1, 2018 Accepting new patients
Providence Health & Services - Oregon Family Medicine Past Accepting new patients

Locations

1001 N Providence Dr
Newberg, OR 97132
Phone (503) 216-1538

1000 N Providence Dr
Ste 210
Newberg, OR 97132

1000 N Providence Dr
Ste 120
Newberg, OR 97132
Phone (503) 537-5700

1003 N Providence Dr
Ste 325
Newberg, OR 97132
Phone (503) 216-1661

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

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212

29345 SW Town Center Loop E
Ste 110
Wilsonville, OR 97070
Phone (503) 582-2100

1002 N Boones Ferry Rd
Woodburn, OR 97071
Phone (503) 981-9526

Interoperability endpoints

  • Direct secure messaging: ahawthorne945487@oc.providencedirect.org

Organizations & group practices 11

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1369526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1922445394",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N PROVIDENCE DR STE 210",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971327582",
            "telephone_number": "503-537-5900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1002 N Boones Ferry Rd",
            "address_purpose": "LOCATION",
            "city": "Woodburn",
            "state": "OR",
            "postal_code": "970719602",
            "country_code": "US",
            "telephone_number": "503-981-9602",
            "fax_number": "503-414-8535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAWTHORNE",
        "first_name": "ANNALISA",
        "middle_name": "COLLEEN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-26",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO172429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ahawthorne945487@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1000 N Providence Dr Ste 210",
            "city": "Newberg",
            "state": "OR",
            "country_code": "US",
            "postal_code": "971327582",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANNALISA",
            "last_name": "WOOD",
            "middle_name": "COLEEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newberg, OR

Sources for this page

Verify at the official NPI Registry.