Individual provider Active NPI

Darlena Rose Pike, FNP

  • Family Nurse Practitioner
  • Grants Pass, OR
National Provider Identifier
1255614160
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201150132NP Issued in OR
Practice address
1201 NE 7TH St Ste E
Grants Pass, OR 97526-1451
Phone
(541) 314-4894
Fax
(541) 862-2806
NPI assigned
Sep 27, 2011
Last updated
Mar 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201150132NP OR Primary

Addresses

Primary practice location

1201 NE 7TH St Ste E
Grants Pass, OR 97526-1451

Mailing address

1201 NE 7TH St Ste E
Grants Pass, OR 97526-1451
Phone (541) 314-4894

Other identifiers 1

IdentifierTypeStateIssuer
500642365MedicaidOR

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
I20111213000042 OR Practitioner - Nurse Practitioner 3971778481 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1201 NE 7TH St
Suite E
Grants Pass, OR 97526-1451
Phone (541) 314-4894

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201150132NPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Life Medical Practice LLC CurrentSince Oct 1, 2020 Accepting new patients

Locations

1201 NE 7th St
Ste E
Grants Pass, OR 97526
Phone (541) 314-4894

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BAAADD/Endpoint/BAAADD

Organizations & group practices 1

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": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1255614160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 NE 7TH ST STE E",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261451",
            "telephone_number": "541-314-4894",
            "fax_number": "541-314-4895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 NE 7TH ST STE E",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261451",
            "telephone_number": "541-314-4894",
            "fax_number": "541-862-2806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIKE",
        "first_name": "DARLENA",
        "middle_name": "ROSE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-27",
        "last_updated": "2021-03-04",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201150132NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500642365",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

Verify at the official NPI Registry.