Active NPI
Brianne Kanehl, FNP
- Family Nurse Practitioner
- La Pine, OR
National Provider Identifier
1053973099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 201905160
- 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
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 |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 201905160 | OR | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Icco, LLC | Current | Accepting new patients | |
| Icco LLC | Current | Accepting new patients | |
| WFM Healthcare, P.C. | Current | Accepting new patients | |
| Icco, LLC | Current | Accepting new patients | |
| Paulina Peak Family Healthcare Inc | Family | Past | 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
- 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.
-
- Rural Health Clinic/Center
- Florence, OR
- NPI 1740896547
-
- Family Medicine Physician
- Eugene, OR
- NPI 1992861611
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.