Active NPI
Kimberly Jean Powell, CNM
- Women's Health Nurse Practitioner
- Corvallis, OR
National Provider Identifier
1104126861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- 201800946NP-PP
- Practice address
- 444 NW Elks Dr
Corvallis, OR 97330-3745 - Phone
- (541) 754-1150
- NPI assigned
- Oct 28, 2010
- 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 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Women's Health Care Registered Nurse | 163WW0101X | 8399023-4405 | UT | |
| Ambulatory Women's Health Care Registered Nurse | 163WW0101X | NP2618 | CA | |
| Midwife | 176B00000X | NM1319 | CA | |
| Advanced Practice Midwife | 367A00000X | 201406025NP-PP | OR | |
| Advanced Practice Midwife | 367A00000X | 8399023-4402 | UT | |
| Women's Health Nurse Practitioner | 363LW0102X | 201800946NP-PP | OR | Primary |
Addresses
Primary practice location
444 NW Elks Dr
Corvallis, OR 97330-3745
Mailing address
444 NW Elks Dr
Corvallis, OR 97330-3745
Phone (541) 754-1150
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)
- Enrolled
- Credentials
- Certified Nurse Midwife, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NP2618 | CA | MD | Ambulatory Women's Health Care Registered Nurse |
| 8399023-4405 | UT | MD | Ambulatory Women's Health Care Registered Nurse |
| NM1319 | CA | MD | Midwife |
| 201800946NP-PP | OR | MD | Women's Health Nurse Practitioner |
| 201406025NP-PP | OR | MD | Advanced Practice Midwife |
| 8399023-4402 | UT | MD | Advanced Practice Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522800000000",
"number": "1104126861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "444 NW ELKS DR",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973303745",
"telephone_number": "541-754-1150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "444 NW ELKS DR",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973303745",
"telephone_number": "541-754-1150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POWELL",
"first_name": "KIMBERLY",
"middle_name": "JEAN",
"credential": "CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-28",
"last_updated": "2018-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "163WW0101X",
"taxonomy_group": "",
"desc": "Registered Nurse, Women's Health Care, Ambulatory",
"state": "UT",
"license": "8399023-4405",
"primary": false
},
{
"code": "163WW0101X",
"taxonomy_group": "",
"desc": "Registered Nurse, Women's Health Care, Ambulatory",
"state": "CA",
"license": "NP2618",
"primary": false
},
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "CA",
"license": "NM1319",
"primary": false
},
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "OR",
"license": "201406025NP-PP",
"primary": false
},
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "UT",
"license": "8399023-4402",
"primary": false
},
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "OR",
"license": "201800946NP-PP",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Corvallis, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.