Individual provider Active NPI

Elizabeth Anne Roark Yarbrough, RN

  • Registered Nurse
  • Honolulu, HI
National Provider Identifier
1477398048
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
201140391 Issued in OR
Practice address
459 Patterson Rd
Honolulu, HI 96819-1522
Phone
(808) 286-7599
NPI assigned
Jun 26, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 201140391 OR Primary

Addresses

Primary practice location

459 Patterson Rd
Honolulu, HI 96819-1522

Mailing address

12700 NE Dudley Rd
Newberg, OR 97132-6762
Phone (503) 319-5058

Other names 1

  • Elizabeth Anne Roark Former name

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

LicenseStateTypeSpecialty
201140391ORMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1719360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1477398048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12700 NE DUDLEY RD",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971326762",
            "telephone_number": "503-319-5058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 PATTERSON RD",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968191522",
            "telephone_number": "808-286-7599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YARBROUGH",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE ROARK",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-26",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201140391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "ROARK",
            "middle_name": "ANNE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; 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.