Active NPI
Ellen Elizabeth Kerkow, FNP
- Family Nurse Practitioner
- Hillsboro, OR
National Provider Identifier
1205524790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 10005627
- Practice address
- 1925 NE Stucki Ave
Hillsboro, OR 97006-6945 - Phone
- (503) 906-5000
- NPI assigned
- Apr 24, 2023
- 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 | 10005627 | OR | Primary |
Addresses
Primary practice location
1925 NE Stucki Ave
Hillsboro, OR 97006-6945
Mailing address
5734 NE Going St
Portland, OR 97218-2635
Phone (503) 936-0128
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260227004098 | OR | Order and Referring Only - Orthopedic Surgery | 4981186889 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10005627 | OR | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682294400000",
"number": "1205524790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5734 NE GOING ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972182635",
"telephone_number": "503-936-0128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1925 NE STUCKI AVE",
"city": "HILLSBORO",
"state": "OR",
"postal_code": "970066945",
"telephone_number": "503-906-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KERKOW",
"first_name": "ELLEN",
"middle_name": "ELIZABETH",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-24",
"last_updated": "2023-04-24",
"certification_date": "2023-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OR",
"license": "10005627",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hillsboro, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.