Individual provider Active NPI

Hannah Boomer, CNM

  • Advanced Practice Midwife
  • Redmond, OR
National Provider Identifier
1992057491
Registry record updated Apr 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
201404953NP-PP Issued in OR
Practice address
340 NW 5TH St
Redmond, OR 97756-1869
Phone
(541) 526-6635
Fax
(541) 526-6636
NPI assigned
Oct 8, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X AP60306575 WA
Advanced Practice Midwife 367A00000X 201404953NP-PP OR Primary

Addresses

Primary practice location

340 NW 5TH St
Redmond, OR 97756-1869

Mailing address

PO Box 5579
Bend, OR 97708-5579
Phone (541) 706-5920

Other names 1

  • Hannah Renzi Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hrenzi17862@secure.stcharleshealthcare.org

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
I20150611003471 OR Practitioner - Certified Nurse Midwife (CNM) 2062723356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
University of Washington School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Charles Health System IncGroup PAC ID 8729111513, 379 clinicians

Practice addresses (Care Compare)

211 NW Larch Ave
Family Care
Redmond, OR 97756-1357
Phone (541) 548-2164

2600 NE Neff Rd
SCMG Imaging
Bend, OR 97701-6337
Phone (541) 706-4905

340 NW 5TH St
101 Cent Women HT
Redmond, OR 97756-1869
Phone (541) 526-6635

Hospital & facility affiliations

  • St Charles Medical Center - Bend Hospital, Bend, OR, CCN 380047

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP60306575WAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
St. Charles Health System, Inc. CurrentSince May 1, 2015 Accepting new patients
St. Charles Health System, Inc. CurrentSince May 1, 2015 Accepting new patients

Locations

29358 Network Pl
Chicago, IL 60673

2500 NE Neff Rd
Bend, OR 97701
Phone (541) 388-4333

1885 NE Purcell Blvd
Bend, OR 97701
Phone (541) 322-2700

2600 NE Neff Rd
Bend, OR 97701
Phone (541) 706-3700

61250 SE Coombs Pl
Bend, OR 97702
Phone (541) 706-5930

51781 Huntington Rd
La Pine, OR 97739
Phone (541) 666-7920

384 SE Combs Flat Rd
Prineville, OR 97754
Phone (541) 383-3668

211 NW Larch Ave
Redmond, OR 97756
Phone (541) 548-2164

340 NW 5th St
Ste 101
Redmond, OR 97756
Phone (734) 545-3348

1253 NW Canal Blvd
Redmond, OR 97756
Phone (541) 548-8131

340 NW 5th St
Redmond, OR 97756
Phone (541) 504-2218

630 N Arrowleaf Trl
Sisters, OR 97759
Phone (541) 549-1318

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 and National Provider Directory roles.

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": "1349654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1992057491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5579",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977085579",
            "telephone_number": "541-706-5920",
            "fax_number": "541-706-5925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 NW 5TH ST",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561869",
            "telephone_number": "541-526-6635",
            "fax_number": "541-526-6636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOMER",
        "first_name": "HANNAH",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-08",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "WA",
            "license": "AP60306575",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "OR",
            "license": "201404953NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hrenzi17862@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "340 NW 5th St",
            "city": "Redmond",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977561869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "HANNAH",
            "last_name": "RENZI",
            "credential": "CNM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Redmond, OR

Sources for this page

Verify at the official NPI Registry.