Active NPI
Edith Donnelly
- General Practice Registered Nurse
- Milwaukie, OR
National Provider Identifier
1013425156
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Apr 20, 2026.
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Registered Nurse
- License
- 200440840RN
- Practice address
- 4115 SE Hager LN
Milwaukie, OR 97267-2925 - Phone
- (716) 491-0350
- NPI assigned
- Jan 10, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Registered Nurse | 163WG0000X | 200440840RN | OR | Primary |
Addresses
Primary practice location
4115 SE Hager LN
Milwaukie, OR 97267-2925
Mailing address
25143 S Loma Linda Dr
Beavercreek, OR 97004-9643
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200440840RN | OR | MD | General Practice Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515542400000",
"number": "1013425156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25143 S LOMA LINDA DR",
"city": "BEAVERCREEK",
"state": "OR",
"postal_code": "970049643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4115 SE HAGER LN",
"city": "MILWAUKIE",
"state": "OR",
"postal_code": "972672925",
"telephone_number": "716-491-0350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONNELLY",
"first_name": "EDITH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-10",
"last_updated": "2018-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "163WG0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, General Practice",
"state": "OR",
"license": "200440840RN",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milwaukie, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.