Individual provider Active NPI

Brianne Kanehl, FNP

  • Family Nurse Practitioner
  • La Pine, OR
National Provider Identifier
1053973099
Registry record updated Jun 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201905160 Issued in OR
Practice address
51600 Huntington Rd
La Pine, OR 97739-8887
Phone
(541) 536-3435
NPI assigned
Jun 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2019

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 201905160 OR Primary

Addresses

Primary practice location

51600 Huntington Rd
La Pine, OR 97739-8887

Mailing address

19994 Rock Bluff Cir
Bend, OR 97702-2033
Phone (904) 472-5926

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
I20190903002827 OR Practitioner - Nurse Practitioner 4789913567 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WFM Healthcare PC 5 clinicians

Practice addresses (Care Compare)

2564 NE Courtney Dr
Bend, OR 97701-7638
Phone (541) 678-5277

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201905160ORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Icco, LLC Current Accepting new patients
Icco LLC CurrentSince Jan 11, 2021 Accepting new patients
WFM Healthcare, P.C. CurrentSince Sep 1, 2021 Accepting new patients
Icco, LLC CurrentSince Jan 11, 2021 Accepting new patients
Paulina Peak Family Healthcare Inc Family PastSince Sep 1, 2021 Accepting new patients

Locations

2564 NE Courtney Dr
Bend, OR 97701
Phone (541) 678-5277

598 E 13th Ave
Eugene, OR 97401
Phone (541) 636-3473

Interoperability endpoints

  • Direct secure messaging: bkanehl24413@coipa.gardenplot.direct-ci.com

Organizations & group practices 5

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": "1561852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561852800000",
    "number": "1053973099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19994 ROCK BLUFF CIR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977022033",
            "telephone_number": "904-472-5926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51600 HUNTINGTON RD",
            "city": "LA PINE",
            "state": "OR",
            "postal_code": "977398887",
            "telephone_number": "541-536-3435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANEHL",
        "first_name": "BRIANNE",
        "name_prefix": "Miss",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-30",
        "last_updated": "2019-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201905160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Pine, OR

Sources for this page

Verify at the official NPI Registry.