Individual provider Active NPI

Bethany Jean Stairs, FNP

  • Family Nurse Practitioner
  • Portland, OR
National Provider Identifier
1992027866
Registry record updated Jan 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19321 Issued in CA
Practice address
124 NE 181St Ave Ste 103
Portland, OR 97230-6565
Phone
(503) 489-1760
NPI assigned
Feb 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 19321 CA Primary

Addresses

Primary practice location

124 NE 181St Ave Ste 103
Portland, OR 97230-6565

Mailing address

124 NE 181St Ave Ste 103
Portland, OR 97230-6565
Phone (503) 489-1760

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
I20161014001850 OR Practitioner - Nurse Practitioner 2769674456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of California, Geffen School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Wallace Medical ConcernGroup PAC ID 2365680865, 10 clinicians

Practice addresses (Care Compare)

18633 SE Stark St
Portland, OR 97233-5468
Phone (503) 489-1760

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: bstairs185060@direct.ochin.org

Organizations & group practices 1

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": "1266537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547424000000",
    "number": "1992027866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 NE 181ST AVE STE 103",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972306565",
            "telephone_number": "503-489-1760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 NE 181ST AVE STE 103",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972306565",
            "telephone_number": "503-489-1760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAIRS",
        "first_name": "BETHANY",
        "middle_name": "JEAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-19",
        "last_updated": "2019-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "19321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.