Individual provider Active NPI

Mary Kristine Horton, A.N.P.

  • Registered Nurse
  • Portland, OR
National Provider Identifier
1043395619
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
Practice address
2701 NW Vaughn St
#305
Portland, OR 97210-5311
Phone
(503) 279-8252
Fax
(503) 279-8926
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 000026282N3 ANP-PP OR
Registered Nurse 163W00000X OR Primary

Addresses

Primary practice location

2701 NW Vaughn St
#305
Portland, OR 97210-5311

Mailing address

12381 SE Crest Way
Happy Valley, OR 97236-6177
Phone (503) 421-2367

Other identifiers 1

IdentifierTypeStateIssuer
270439MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000026282RNORMDRegistered Nurse
000026282N3 ANP-PPORMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1043395619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12381 SE CREST WAY",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "972366177",
            "telephone_number": "503-421-2367",
            "fax_number": "503-279-8926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 NW VAUGHN ST",
            "address_2": "#305",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972105311",
            "telephone_number": "503-279-8252",
            "fax_number": "503-279-8926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORTON",
        "first_name": "MARY",
        "middle_name": "KRISTINE",
        "name_prefix": "Ms.",
        "credential": "A.N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "000026282N3 ANP-PP",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270439",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.