Individual provider Active NPI

Peri Rose Vernon, CNM

  • Advanced Practice Midwife
  • Bend, OR
National Provider Identifier
1962121665
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
202213045NP-PP Issued in OR
Practice address
2400 NE Neff Rd Ste a
Bend, OR 97701-6752
Phone
(541) 389-3300
Fax
(541) 389-8115
NPI assigned
Aug 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 202213045NP-PP OR Primary

Addresses

Primary practice location

2400 NE Neff Rd Ste a
Bend, OR 97701-6752

Mailing address

2124 SW 28TH St
Redmond, OR 97756-8078
Phone (541) 647-7377

Other identifiers 3

IdentifierTypeStateIssuer
CNM07819OtherAMCB
500820093MedicaidOR
202213045NP-PPOtherOROREGON STATE BOARD OF NURSING

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
I20231116002995 OR Practitioner - Certified Nurse Midwife (CNM) 3476900192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Georgetown University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Cascade Womens Group P CGroup PAC ID 9638166796, 18 clinicians

Practice addresses (Care Compare)

2400 NE Neff Rd
Suite a
Bend, OR 97701-6752
Phone (541) 389-3300

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
East Cascade Womens Group, P C CurrentSince Nov 1, 2023 Accepting new patients
St. Charles Health System, Inc. PastSince Nov 1, 2023 Accepting new patients

Locations

2400 NE Neff Rd
Ste A
Bend, OR 97701
Phone (541) 389-3300

Interoperability endpoints

  • FHIR API: https://epicproxy.et4001.epichosted.com/APIProxyPRD/ECWG/api/FHIR/R4
  • Direct secure messaging: pvernon24441@coipa.gardenplot.direct-ci.com

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.

Hospital & facility affiliations 2

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": "1661385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1962121665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 SW 28TH ST",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977568078",
            "telephone_number": "541-647-7377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 NE NEFF RD STE A",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016752",
            "telephone_number": "541-389-3300",
            "fax_number": "541-389-8115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERNON",
        "first_name": "PERI",
        "middle_name": "ROSE",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-25",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "OR",
            "license": "202213045NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMCB",
            "identifier": "CNM07819",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500820093",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON STATE BOARD OF NURSING",
            "identifier": "202213045NP-PP",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.