Individual provider Active NPI

Amelie Jane Noel

  • Licensed Practical Nurse
  • Salem, OR
National Provider Identifier
1366940702
Registry record updated Jan 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
200830346LPN Issued in OR
Practice address
4235 Wheat CT NE
Salem, OR 97305-2388
Phone
(503) 758-3194
Fax
(503) 776-9048
NPI assigned
Jan 31, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 200830346LPN OR Primary

Addresses

Primary practice location

4235 Wheat CT NE
Salem, OR 97305-2388

Mailing address

11920 Fargo Rd NE
Aurora, OR 97002-8686
Phone (503) 758-3194

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

State licenses

LicenseStateTypeSpecialty
200830346LPNORMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517356800000",
    "number": "1366940702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11920 FARGO RD NE",
            "city": "AURORA",
            "state": "OR",
            "postal_code": "970028686",
            "telephone_number": "503-758-3194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4235 WHEAT CT NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973052388",
            "telephone_number": "503-758-3194",
            "fax_number": "503-776-9048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOEL",
        "first_name": "AMELIE",
        "middle_name": "JANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-31",
        "last_updated": "2018-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OR",
            "license": "200830346LPN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2018; 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.