Individual provider Active NPI

Noelle Hashimoto Nurre, PNP

  • Pediatric Nurse Practitioner
  • Portland, OR
National Provider Identifier
1043342884
Registry record updated Jan 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
095000173N2 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Mail Code DC8N
Portland, OR 97239-3011
Phone
(503) 418-5196
Fax
(503) 418-5199
NPI assigned
Mar 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 095000173RN OR
Pediatric Nurse Practitioner 363LP0200X 095000173N2 OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
Mail Code DC8N
Portland, OR 97239-3011

Mailing address

6222 Barlow St
West Linn, OR 97068-3040
Phone (503) 418-8208

Other names 1

  • Mrs. Noelle Emi Gibson Former name

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
I20070502000219 OR Practitioner - Nurse Practitioner 8426154873 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
095000173RNORMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services Registered Nurse CurrentSince May 5, 2009 Accepting new patients
University Professional Services CurrentSince May 5, 2009 Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

3181 SW Sam Jackson Park Rd
#8N
Portland, OR 97239
Phone (503) 494-4314

Interoperability endpoints

  • Direct secure messaging: ngibsonpnp9349@direct.ohsu.edu

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452729600000",
    "number": "1043342884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6222 BARLOW ST",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970683040",
            "telephone_number": "503-418-8208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "MAIL CODE DC8N",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-418-5196",
            "fax_number": "503-418-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NURRE",
        "first_name": "NOELLE",
        "middle_name": "HASHIMOTO",
        "name_prefix": "Mrs.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2016-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "095000173RN",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OR",
            "license": "095000173N2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NOELLE",
            "last_name": "GIBSON",
            "middle_name": "EMI",
            "prefix": "MRS.",
            "credential": "PNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.