Active NPI
Kelly Irene Wells, FNP
- Family Nurse Practitioner
- Beaverton, OR
National Provider Identifier
1336591197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 201604735NP-PP
- Practice address
- 11000 SW Stratus St Ste 310
Beaverton, OR 97008-7144 - Phone
- (503) 297-3778
- Fax
- (503) 297-7853
- NPI assigned
- Jul 5, 2016
- Last updated
- May 15, 2026
- 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 | 201604735NP-PP | OR | Primary |
Addresses
Primary practice location
11000 SW Stratus St Ste 310
Beaverton, OR 97008-7144
Mailing address
541 NE 20TH Ave Ste 225
Portland, OR 97232-2895
Phone (503) 963-2801
Other practice location 1
879 N Providence Dr
Newberg, OR 97132-7563
Phone (503) 297-3778
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2142278 | Medicaid | WA | |
| 500711227 | Medicaid | OR |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | cc_otoc_pulmonology_west_front_desk12223305@oc.providencedirect.org | The Oregon Clinic PC |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
11000 SW Stratus St
Suite 310
Beaverton, OR 97008-7144
Phone (503) 297-3778
5050 NE Hoyt
Suite 655
Portland, OR 97213-2990
Phone (503) 239-6673
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Interoperability endpoints
- kwells270492@oc.providencedirect.org
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.
-
- Specialist
- Portland, OR
- NPI 1265417174
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Providence St Vincent Medical Center
- General Acute Care Hospital
- Portland, OR
- NPI 1114015971
-
dba Providence Newberg Medical Center
- General Acute Care Hospital
- Newberg, OR
- NPI 1952482275
-
dba Providence Milwaukie Hospital
- General Acute Care Hospital
- Milwaukie, OR
- NPI 1366536963
-
dba Providence Seaside Hospital
- Critical Access Hospital
- Seaside, OR
- NPI 1578500492
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778803200000",
"number": "1336591197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "541 NE 20TH AVE STE 225",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972322895",
"telephone_number": "503-963-2801",
"fax_number": "503-963-2825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11000 SW STRATUS ST STE 310",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970087144",
"telephone_number": "503-297-3778",
"fax_number": "503-297-7853"
}
],
"practiceLocations": [
{
"address_1": "879 N Providence Dr",
"address_purpose": "LOCATION",
"city": "Newberg",
"state": "OR",
"postal_code": "971327563",
"country_code": "US",
"telephone_number": "503-297-3778",
"fax_number": "503-297-7853",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WELLS",
"first_name": "KELLY",
"middle_name": "IRENE",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-05",
"last_updated": "2026-05-15",
"certification_date": "2026-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OR",
"license": "201604735NP-PP",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2142278",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500711227",
"state": "OR"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "cc_otoc_pulmonology_west_front_desk12223305@oc.providencedirect.org",
"affiliation": "Y",
"affiliationName": "The Oregon Clinic PC",
"address_1": "11000 SW Stratus St Ste 310",
"city": "Beaverton",
"state": "OR",
"country_code": "US",
"postal_code": "970087144",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2026; 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.