Kemble Green, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

201600268NP-PP Issued in OR

Practice address

10365 SE Sunnyside Rd Ste 340
Clackamas, OR 97015-5751

Phone

(541) 579-2800

NPI assigned

Jan 13, 2016

Last updated

May 13, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR, WA, HI, NM, CA, TX6 enrollments

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 6

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Daiya Healthcare PLLCGroup PAC ID 6002158615, 80 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health Care Home health agency, Roseburg, OR, CCN 387311
• Mercy Medical Center Hospital, Roseburg, OR, CCN 380027

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Daiya Healthcare PLLC

  • Internal Medicine Physician
  • Bellevue, WA
  • NPI 1477027381

  CA, NM, OR, TX

  Medicare reassignment Care Compare group
• Bristol Advanced Illness Management - Oregon, L.L.C.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Springfield, OR
  • NPI 1083364749
  Medicare reassignment NPD
• CRM Physicians, LLC

  dba Ascent Healthcare

  • Internal Medicine Physician
  • Beaverton, OR
  • NPI 1952674996

  Gerontology

  Medicare reassignment NPD
• Peacehealth

  dba Sacred Heart Physicians

  • Hospitalist Physician
  • Springfield, OR
  • NPI 1740223874
  Medicare reassignment NPD
• Peacehealth Medical Group

  • Family Medicine Physician
  • Eugene, OR
  • NPI 1447207287
  Medicare reassignment NPD
• Daiya Healthcare PC

  • Internal Medicine Physician
  • San Ramon, CA
  • NPI 1265100614
  Medicare reassignment
• Peacehealth

  dba Sacred Heart-RiverBend

  • General Acute Care Hospital
  • Springfield, OR
  • NPI 1083888515
  NPD (past)
• Providence Health & Services - Oregon

  dba Providence Portland Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1003991845
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Amedisys Oregon, L.L.C.

  dba Amedisys Home Health Care

  • Home Health Agency
  • Roseburg, OR
  • NPI 1093908725
  Care Compare affiliation
• Commonspirit Oregon

  dba CHI Mercy Medical Center

  • General Acute Care Hospital
  • Roseburg, OR
  • NPI 1477590198
  Care Compare affiliation

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

{
    "created_epoch": "1452643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1205292703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1077 GATEWAY LOOP",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974771114",
            "telephone_number": "423-335-0929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10365 SE SUNNYSIDE RD STE 340",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155751",
            "telephone_number": "541-579-2800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1735 Adkins St",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974015003",
            "country_code": "US",
            "telephone_number": "423-335-0929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KEMBLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-13",
        "last_updated": "2021-05-13",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201600267RN",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OR",
            "license": "201600268NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel John Granville, DPM
• Lindsay C Gray
• Siobhan Heidi Gray, M.D.
• Bradi Grebien-Samkow
• Christa Green
• Rory E. Green, M.D.
• Jonathan B Greene, MD
• Ellen Greenfield, OTR/L
• Susanne Greengard
• Carolyn Greenwood

• Gerontology Nurse Practitioner in Clackamas, OR
• Providers in Clackamas, OR by specialty
• Gerontology Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; 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.

Verify at the official NPI Registry.