Denise Kathryn Krackenberger, ACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

201801073NP-PP Issued in OR

Practice address

2700 SE Stratus Ave Unit 406
McMinnville, OR 97128-6258

Phone

(503) 435-1200

Fax

(503) 434-9572

NPI assigned

Jul 11, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Denise Kathryn Antonoff Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA, NE, OR, CO, NH5 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 5

Specialty

Nurse Practitioner

Education

Emory University School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Georgia Heart Institute LLCGroup PAC ID 4183848062, 127 clinicians

Providence Health and Services OregonGroup PAC ID 7315856010, shared by 5 NPIs, 80 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Hood River Memorial Hospital Hospital, Hood River, OR, CCN 381318
• Skyline Hospital Hospital, White Salmon, WA, CCN 501315
• Mid-Columbia Medical Center Hospital, The Dalles, OR, CCN 380001

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dkrackenberger365442@direct.nebraskamed.com
• Direct secure messaging: dkrackenberger730120@direct.unc.nchie.net

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

• Georgia Heart Institute LLC

  • Cardiovascular Disease Physician
  • Gainesville, GA
  • NPI 1477976520
  Medicare reassignment Care Compare group NPD
• Providence Health & Services Oregon

  • Clinical Pathology Physician
  • Hood River, OR
  • NPI 1053862714
  Medicare reassignment NPD
• Providence Health & Services Oregon

  • Critical Access Hospital
  • Hood River, OR
  • NPI 1255429338
  Medicare reassignment NPD
• Catholic Medical Center

  • Cardiovascular Disease Physician
  • Manchester, NH
  • NPI 1386672319
  Medicare reassignment NPD
• Gwinnett Physician Group, LLC

  • Internal Medicine Physician
  • Lawrenceville, GA
  • NPI 1578574661
  Medicare reassignment NPD
• Intermountain Medical Group Grand Junction, LLC

  • Orthopaedic Surgery Physician
  • Grand Junction, CO
  • NPI 1356765556
  Medicare reassignment NPD
• North Platte Nebraska Hospital Corporation

  • General Acute Care Hospital
  • North Platte, NE
  • NPI 1700855533
  Medicare reassignment NPD
• Providence Health & Services Oregon

  • Rural Health Clinic/Center
  • Hood River, OR
  • NPI 1073100095
  NPD
• Catholic Medical Center

  • Anesthesiology Physician
  • Manchester, NH
  • NPI 1003692112
  NPD
• Intermountain Medical Group Grand Junction, LLC

  • Durable Medical Equipment & Medical Supplies
  • Grand Junction, CO
  • NPI 1609737618
  NPD
• North Platte Nebraska Hospital Corporation

  • Medical Oncology Physician
  • North Platte, NE
  • NPI 1134355332
  NPD
• Northeast Georgia Heart Center

  • Cardiovascular Disease Physician
  • Gainesville, GA
  • NPI 1508812421
  NPD

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

• Mid-Columbia Medical Center

  • Critical Access Hospital Clinic/Center
  • The Dalles, OR
  • NPI 1306842752
  Care Compare affiliation
• Providence Health & Services Oregon

  • Critical Access Hospital
  • Hood River, OR
  • NPI 1255429338
  Care Compare affiliation
• Public Hospital District No. 2, Klickitat County, Washington

  • Critical Access Hospital
  • White Salmon, WA
  • NPI 1760455687
  Care Compare affiliation

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

{
    "created_epoch": "1215734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1316101082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 SE STRATUS AVE UNIT 406",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971286258",
            "telephone_number": "503-435-1200",
            "fax_number": "503-434-9572"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6935 Full Harvest Ct.",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300284777",
            "country_code": "US",
            "telephone_number": "706-344-2987",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4420 Lake Boone Trl",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276077505",
            "country_code": "US",
            "telephone_number": "919-784-3542",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "743 Spring St NE",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305013715",
            "country_code": "US",
            "telephone_number": "770-219-8420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRACKENBERGER",
        "first_name": "DENISE",
        "middle_name": "KATHRYN",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-11",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NC",
            "license": "5014649",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN151196",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OR",
            "license": "201801073NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dkrackenberger730120@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "4420 Lake Boone Trl",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276077505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DENISE",
            "last_name": "ANTONOFF",
            "middle_name": "KATHRYN",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• William J. Koenig, D.O.
• Daphna Rivah Kohn, LAC
• Thomas A Kolodge, DDS, MD
• Jana Konkolewski
• Thomas Konkolewski
• Gabrielle Krause
• Dag Kremer, M.D.
• Bobbi J Krogh
• Nana Ama Agyeiwah Kuffour, PHARM.D
• Sandeep Kumar, M.D.

• Acute Care Nurse Practitioner in McMinnville, OR
• Providers in McMinnville, OR by specialty
• Acute Care Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.