Individual provider Active NPI

Richina M.K. Davis, LPN

  • Licensed Practical Nurse
  • Estacada, OR
National Provider Identifier
1245715366
Registry record updated Sep 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
201807395LPN Issued in OR
Practice address
59110 E Highway 224
Estacada, OR 97023-9305
Phone
(503) 936-9647
NPI assigned
Sep 25, 2018
Sex
Female
Sole proprietor
No

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

State licenses

LicenseStateTypeSpecialty
201807395LPNORMDLicensed Practical Nurse

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 201807395LPN OR Primary

Addresses

NPPES NPI Registry

Primary practice location

59110 E Highway 224
Estacada, OR 97023-9305

Mailing address

59110 E Highway 224
Estacada, OR 97023-9305
Phone (503) 936-9647

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 25, 2018.

{
    "created_epoch": "1537833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537833600000",
    "number": "1245715366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59110 E HIGHWAY 224",
            "city": "ESTACADA",
            "state": "OR",
            "postal_code": "970239305",
            "telephone_number": "503-936-9647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59110 E HIGHWAY 224",
            "city": "ESTACADA",
            "state": "OR",
            "postal_code": "970239305",
            "telephone_number": "503-936-9647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "RICHINA",
        "middle_name": "M.K.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-25",
        "last_updated": "2018-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OR",
            "license": "201807395LPN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Estacada, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.

Verify at the official NPI Registry.