Individual provider Active NPI

Kelsey Rose Hupp, FNP

  • Family Nurse Practitioner
  • Silverton, OR
National Provider Identifier
1003169285
Registry record updated Sep 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201350091NP Issued in OR
Practice address
111 W C St
Silverton, OR 97381-1458
Phone
(503) 874-4747
Fax
(503) 874-4638
NPI assigned
Oct 24, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2018

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 201350091NP OR Primary

Addresses

Primary practice location

111 W C St
Silverton, OR 97381-1458

Mailing address

111 W C St
Silverton, OR 97381-1458

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
I20130827000257 OR Practitioner - Nurse Practitioner 9638312440 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Silver Creek Family MedicineGroup PAC ID 5496016248, 5 clinicians

Practice addresses (Care Compare)

111 W C St
Silverton, OR 97381-1458
Phone (503) 874-4747

Hospital & facility affiliations

  • Legacy Silverton Medical Center Hospital, Silverton, OR, CCN 380029
  • Santiam Hospital & Clinics Hospital, Stayton, OR, CCN 380056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Creek Family Medicine CurrentSince Sep 25, 2018 Accepting new patients

Locations

111 W C St
Silverton, OR 97381
Phone (503) 873-6111

Networks

  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e
  • WA PPO C-SNP

Interoperability endpoints

  • Direct secure messaging: khupp204824@direct.lhs.org
  • Direct secure messaging: clinical@fmgosm.directbygreenway.com

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.

Hospital & facility affiliations 3

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": "1351036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537833600000",
    "number": "1003169285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W C ST",
            "city": "SILVERTON",
            "state": "OR",
            "postal_code": "973811458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W C ST",
            "city": "SILVERTON",
            "state": "OR",
            "postal_code": "973811458",
            "telephone_number": "503-874-4747",
            "fax_number": "503-874-4638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUPP",
        "first_name": "KELSEY",
        "middle_name": "ROSE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-24",
        "last_updated": "2018-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201350091NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silverton, OR

Sources for this page

Verify at the official NPI Registry.