Individual provider Active NPI

Nicole McKenna, FNP, RN, BSN

  • Family Nurse Practitioner
  • Oregon City, OR
National Provider Identifier
1235569278
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201506515NP-PP Issued in OR
Practice address
1425 Beavercreek Rd
Oregon City, OR 97045-4076
Phone
(503) 655-8471
Fax
(503) 723-4946
NPI assigned
Nov 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 201041543RN OR
Family Nurse Practitioner 363LF0000X 201506515NP-PP OR Primary

Addresses

Primary practice location

1425 Beavercreek Rd
Oregon City, OR 97045-4076

Mailing address

2051 Kaen Rd Ste 367
Oregon City, OR 97045-4035
Phone (503) 742-5300

Other names 1

  • Nicole Webber Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150923003263 OR Practitioner - Nurse Practitioner 4880901867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

110 Beavercreek Rd
Oregon City, OR 97045-4307
Phone (503) 655-8471

150 Beavercreek Rd
Oregon City, OR 97045-4302

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
201506515NP-PPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Clackamas Office of County Auditor CurrentSince Sep 28, 2015 Accepting new patients
Clackamas County Current Accepting new patients
Clackamas County Past Accepting new patients

Locations

2051 Kaen Rd
Ste 367
Oregon City, OR 97045
Phone (503) 742-5300

110 Beavercreek Rd
Ste 100
Oregon City, OR 97045
Phone (503) 655-8374

110 Beavercreek Rd
Oregon City, OR 97045
Phone (503) 655-8470

39740 Pleasant St
Sandy, OR 97055
Phone (503) 563-7679

Interoperability endpoints

  • Direct secure messaging: nwebber125813@direct.ochin.org

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1384214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1235569278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 KAEN RD STE 367",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970454035",
            "telephone_number": "503-742-5300",
            "fax_number": "503-742-5979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 BEAVERCREEK RD",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970454076",
            "telephone_number": "503-655-8471",
            "fax_number": "503-723-4946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENNA",
        "first_name": "NICOLE",
        "credential": "FNP, RN, BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-12",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201041543RN",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201506515NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "WEBBER",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oregon City, OR

Sources for this page

Verify at the official NPI Registry.