Individual provider Active NPI

Nicole McKnight

  • Nurse Practitioner
  • Portland, OR
National Provider Identifier
1407165756
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
201710254NP-PP Issued in OR
Practice address
8935 SE Powell Blvd
Portland, OR 97266
Phone
(503) 772-4335
Fax
(503) 772-4337
NPI assigned
Oct 5, 2010
Last updated
Aug 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 201709785RN OR
Nurse Practitioner 363L00000X 201710254NP-PP OR Primary
Family Nurse Practitioner 363LF0000X 5004889 NC

Addresses

Primary practice location

8935 SE Powell Blvd
Portland, OR 97266

Mailing address

8935 SE Powell Blvd
Portland, OR 97266-1938
Phone (503) 772-4335

Other practice location 1

10373 NE Hancock St Ste 200
Portland, OR 97220-3873
Phone (503) 253-6754

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180911000853 OR Practitioner - Nurse Practitioner 2163617366 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cascadia HealthGroup PAC ID 7618873761, 53 clinicians

Practice addresses (Care Compare)

10373 NE Hancock St
Suite 200
Portland, OR 97220-3873
Phone (503) 253-6754

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201709785RNORMDNurse Practitioner
5004889NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cascadia Health CurrentSince Aug 8, 2022 Accepting new patients
Cascadia Health CurrentSince Aug 8, 2022 Accepting new patients
Multnomah County CurrentSince Jul 1, 2021 Accepting new patients
Multnomah County Current Accepting new patients
Multnomah County CurrentSince Jul 1, 2021 Accepting new patients
Cascadia Health Past Accepting new patients

Locations

600 NE 8th St
Gresham, OR 97030
Phone (503) 988-4900

10373 NE Hancock St
Ste 200
Portland, OR 97220
Phone (503) 253-6754

209 SW 4th Ave
Ste 210
Portland, OR 97204
Phone (503) 988-3674

6736 NE Killingsworth St
Portland, OR 97218
Phone (503) 988-3601

707 NW Everett St
Portland, OR 97209
Phone (503) 222-4906

Interoperability endpoints

  • Direct secure messaging: nmcknight665431@direct.ochin.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1407165756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8935 SE POWELL BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972661938",
            "telephone_number": "503-772-4335",
            "fax_number": "503-772-4337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8935 SE POWELL BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97266",
            "telephone_number": "503-772-4335",
            "fax_number": "503-772-4337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10373 NE Hancock St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972203873",
            "country_code": "US",
            "telephone_number": "503-253-6754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKNIGHT",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-05",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "201709785RN",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "201710254NP-PP",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5004889",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.