Active NPI
Hannah Park, RN
- Registered Nurse
- Ashland, OR
National Provider Identifier
1366716219
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 201240056RN
- Practice address
- 215 Mobile Dr
Ashland, OR 97520-9021 - Phone
- (541) 282-3603
- NPI assigned
- Feb 23, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 201240056RN | OR | Primary |
Addresses
Primary practice location
215 Mobile Dr
Ashland, OR 97520-9021
Mailing address
455 Drager St
Ashland, OR 97520-1102
Phone (608) 632-1784
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GU401B6H | Medicaid | OR |
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201240056RN | OR | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329955200000",
"number": "1366716219",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "455 DRAGER ST",
"city": "ASHLAND",
"state": "OR",
"postal_code": "975201102",
"telephone_number": "608-632-1784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 MOBILE DR",
"city": "ASHLAND",
"state": "OR",
"postal_code": "975209021",
"telephone_number": "541-282-3603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "HANNAH",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-02-23",
"last_updated": "2012-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OR",
"license": "201240056RN",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GU401B6H",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ashland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.