Kelly Robyn Vinzant

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

200111433CNA Issued in OR

Practice address

4805 NE Glisan St
Portland, OR 97213-2933

Phone

(503) 215-1111

NPI assigned

Mar 24, 2025

Last updated

Mar 24, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1742774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1356142475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2349 SE 152ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972333400",
            "telephone_number": "971-724-4634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132933",
            "telephone_number": "503-215-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINZANT",
        "first_name": "KELLY",
        "middle_name": "ROBYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-24",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "OR",
            "license": "200111433CNA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan L Vinson, MD
• Sarah L Vinson, LMT
• Zachary Ryan Vinson, LMT
• Tawnie Ruth Nan Vinyard Kleckner
• Connor Alex Vinyard, MD
• Elizabeth Hanna Viola, LCSW
• Michael Viola, LPC
• Richard J Viola, QMHP
• Vip Chiropractic Services, LLC
• Zaheeda Virani, PSYD

• Nurse's Aide in Portland, OR
• Providers in Portland, OR by specialty
• Nurse's Aide in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; 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.