Individual provider Active NPI

Zshalie Rochelle Kellison, CMA

  • Clinical Nurse Specialist
  • Hermiston, OR
National Provider Identifier
1154179281
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
R2R9N7G3 Issued in OR
Practice address
595 NW 11TH St
Hermiston, OR 97838-6600
Phone
(541) 567-2536
NPI assigned
May 13, 2024
Last updated
May 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X R2R9N7G3 OR Primary

Addresses

Primary practice location

595 NW 11TH St
Hermiston, OR 97838-6600

Mailing address

PO Box 469
Heppner, OR 97836-0469
Phone (541) 676-9161

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)
Not enrolled
Credentials
Certified Medical Assistant

State licenses

LicenseStateTypeSpecialty
R2R9N7G3ORMDClinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1715558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1154179281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 469",
            "city": "HEPPNER",
            "state": "OR",
            "postal_code": "978360469",
            "telephone_number": "541-676-9161",
            "fax_number": "541-676-5662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 NW 11TH ST",
            "city": "HERMISTON",
            "state": "OR",
            "postal_code": "978386600",
            "telephone_number": "541-567-2536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLISON",
        "first_name": "ZSHALIE",
        "middle_name": "ROCHELLE",
        "credential": "CMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-13",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "OR",
            "license": "R2R9N7G3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermiston, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.