OPTION 1 NORTHWEST ENTERAL, LLC (NPI# 1912101783) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912101783 |
| Entity Type | Organization |
| Organization Name | OPTION 1 NORTHWEST ENTERAL, LLC |
| Other Organization Name | AVEANNA HEALTHCARE MEDICAL SOLUTIONS |
| Practice Address |
7926 Sw Nimbus Ave Suite 8-d Beaverton OR 97008-6435 |
| Mailing Address |
400 Interstate North Pkwy Se Ste 1600 Atlanta GA 30339-5047 |
| Practice Telephone | 8668831188 |
| Practice Fax Number | 5036246713 |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2019-11-13 |
| Authorized Official Name | VICKI WHITESIDE (DIRECTOR REGULATORY LICENSING) |
| Authorized Official Telephone | 7702488740 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332BP3500X |
Durable Medical Equipment & Medical Supplies Specialization: Parenteral & Enteral Nutrition |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 272405 | 05 |
| Other Name | Type Code |
|---|---|
| Aveanna Healthcare Medical Solutions | Doing Business As Name - Organization |
| Epic Medical Solutions | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | OPTION 1 NORTHWEST ENTERAL, LLC | 400 Interstate North Pkwy Se, Ste 1600, Atlanta, GA 30339 |
| Washington State Corporations | OPTION 1 NORTHWEST ENTERAL, LLC | 400 Interstate North Pkwy Se, Ste 1600, Atlanta, GA 30339-5047 |
| Street Address |
7926 SW NIMBUS AVE SUITE 8-D |
| City | BEAVERTON |
| State | OR |
| Zip Code | 97008-6435 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972136638 | Kelly Mitchell | Counselor | 6600 Sw 105th Ave Suite 120, Beaverton, OR 97008 | 2020-02-20 |
| 1700305315 | Heather Denise Glenn | Counselor | 6700 Sw 105th Avenue, Suite 203, Beaverton, OR 97008 | 2017-09-14 |
| 1649798265 | Timothy Wilkins | Counselor | 8285 Sw Nimbus Ave #148, Beaverton, OR 97008 | 2017-09-04 |
| 1962920751 | West End Surgical, LLC | Clinic/Center | 9405 Sw Nimbus Ave, Beaverton, OR 97008 | 2017-09-01 |
| 1073054714 | University Professional Services | Durable Medical Equipment & Medical Supplies | 9317 Sw Nimbus Ave, Beaverton, OR 97008 | 2017-03-14 |
| 1508311424 | Mitra Gaspeed | Dental Hygienist | 8615 Sw Thoroughbred Pl., Beaverton, OR 97008 | 2016-08-20 |
| 1740521988 | Donna Louise Grenier | Registered Nurse | 1413 E St, Independence, OR 97008 | 2013-03-13 |
| 1508105735 | Mary Elizabeth Smith | Specialist/Technologist, Other | 11855sw Ridgecrest Dr, #209, Beaverton, OR 97008 | 2013-02-07 |
| 1629315551 | Adelfino J Zuriaga | Massage Therapist | 11985 Sw Camden Ln, Beaverton, OR 97008 | 2013-01-11 |
| 1760738330 | Lih-wern Wang | Pharmacist | 9775 Sw Gemini Dr Ste 1, Beaverton, OR 97008 | 2012-07-31 |
| Find all providers in zip 97008 | ||||
| Taxonomy Code | 332BP3500X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Parenteral & Enteral Nutrition |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255876454 | Hygeia II Medical Group, Inc. | Durable Medical Equipment & Medical Supplies | 16200 Nw Fescue Ct, Portland, OR 97229-1657 | 2016-12-23 |
| 1144762006 | Hygeia II Medical Group | Durable Medical Equipment & Medical Supplies | 2620 Se 47th Ave, Portland, OR 97206-1504 | 2016-11-09 |
| 1629494562 | Apria Healthcare LLC | Durable Medical Equipment & Medical Supplies | 8427 Ne Cornell Rd Ste 600, Hillsboro, OR 97124-9246 | 2014-03-17 |
| 1336451657 | Norco, Inc. | Durable Medical Equipment & Medical Supplies | 333 Cherry Heights Rd, The Dalles, OR 97058-3586 | 2010-07-02 |
| 1215262738 | Sound Health Medical Supply | Durable Medical Equipment & Medical Supplies | 10130 Sw Nimbus Ave, Ste D9, Tigard, OR 97223 | 2009-10-16 |
| 1841481256 | Norco, Inc. | Durable Medical Equipment & Medical Supplies | 3039 S Highway 97, Redmond, OR 97756-8877 | 2007-08-09 |
| 1972640712 | Optum Infusion Services 404, LLC | Durable Medical Equipment & Medical Supplies | 2065 Ne Williamson Court, Unit B, Bend, OR 97701 | 2007-01-31 |
| 1982757217 | Mms Oklahoma City Inc. | Durable Medical Equipment & Medical Supplies | 540 E Vilas Rd, Suite #b, Central Point, OR 97502-3278 | 2007-01-19 |
| 1841350527 | Option Care At Legacy Health LLC | Durable Medical Equipment & Medical Supplies | 16195 Sw 72nd Avenue, Portland, OR 97224-7766 | 2006-12-11 |
| 1013086594 | Tuality Medical Equipment and Supply | Durable Medical Equipment & Medical Supplies | 1060 Sw Baseline St, Hillsboro, OR 97123-3823 | 2006-11-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.