Individual provider Active NPI

Monelle Larissa Burrus, NP

  • Primary Care Nurse Practitioner
  • Bend, OR
National Provider Identifier
1033707708
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
202100185NP-PP Issued in OR
Practice address
225 SW Scalehouse Loop Unit 106
Bend, OR 97702-1272
Phone
(541) 728-8262
Fax
(541) 203-2202
NPI assigned
Jan 7, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 202100185NP-PP OR Primary

Addresses

Primary practice location

225 SW Scalehouse Loop Unit 106
Bend, OR 97702-1272

Mailing address

2645 NW Sky Vista CT
Bend, OR 97703-8604
Phone (541) 728-8262

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
202100185NP-PPORMDPrimary Care Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1609977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1033707708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2645 NW SKY VISTA CT",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977038604",
            "telephone_number": "541-728-8262",
            "fax_number": "541-203-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 SW SCALEHOUSE LOOP UNIT 106",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021272",
            "telephone_number": "541-728-8262",
            "fax_number": "541-203-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURRUS",
        "first_name": "MONELLE",
        "middle_name": "LARISSA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-07",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OR",
            "license": "202100185NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.