ROBERT MAYER AGPCNP NPI 1154753457

NPI Information

NPI: 1154753457
Provider Name: ROBERT MAYER, AGPCNP
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Individual

Specialization: Gerontology

Organization: JORDAN PHYSICIAN ASSOCIATES INC.

PECOS Registration: Yes

Address:
440 NW DIVISION ST
GRESHAM, OR
ZIP 97030
Phone: (503) 215-9500
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Robert Mayer, AGPCNP is a gerontology nurse practitioner in Gresham, OR with 11 years of experience. Robert Mayer, AGPCNP NPI is 1154753457. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

440 NW DIVISION ST
GRESHAM, OR
ZIP 97030-506
Phone: (503) 215-9500

The NPI 1154753457 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/8/2013 and was last updated on 1/5/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP2300X	Nurse Practitioner	Primary Care	RN2275111	MASSACHUSETTS	No
2	363LP2300X	Nurse Practitioner	Primary Care	201504149NP-PP	OREGON	No
3	363LG0600X	Nurse Practitioner	Gerontology	201504149NP-PP	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	R181926	MEDICARE PIN	OREGON
2	500690883	MEDICAID	OREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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