Active NPI
Patricia K Dudas, CFNP
- Family Nurse Practitioner
- Coos Bay, OR
National Provider Identifier
1447209846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 09400638N1
- Practice address
- 600 Miluk Drive
Coos Bay, OR 97420 - Phone
- (541) 888-9494
- Fax
- (541) 888-4435
- NPI assigned
- May 10, 2006
- 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 | 09400638N1 | OR | Primary |
Addresses
Primary practice location
600 Miluk Drive
Coos Bay, OR 97420
Mailing address
3050 Tremont Street
North Bend, OR 97459
Phone (541) 888-9494
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 165031 | 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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09400638N1 | OR | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coquille Indian Tribe | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Clinic/Center
- Coos Bay, OR
- NPI 1376592287
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289260800000",
"number": "1447209846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3050 TREMONT STREET",
"city": "NORTH BEND",
"state": "OR",
"postal_code": "97459",
"telephone_number": "541-888-9494",
"fax_number": "541-888-4435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 MILUK DRIVE",
"city": "COOS BAY",
"state": "OR",
"postal_code": "97420",
"telephone_number": "541-888-9494",
"fax_number": "541-888-4435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUDAS",
"first_name": "PATRICIA",
"middle_name": "K",
"credential": "CFNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-10",
"last_updated": "2010-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OR",
"license": "09400638N1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "165031",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Coos Bay, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.