Individual provider Active NPI

Jana Rackley, RN

  • Registered Nurse
  • Portland, OR
National Provider Identifier
1477936789
Registry record updated Jul 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
201502037RN Issued in OR
Practice address
4310 NE Killingsworth St
Portland, OR 97218-1404
Phone
(503) 535-1181
NPI assigned
Jul 6, 2015
Last updated
Jul 6, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2015

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 201502037RN OR Primary

Addresses

Primary practice location

4310 NE Killingsworth St
Portland, OR 97218-1404

Mailing address

PO Box 3007
Portland, OR 97208-3007

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
201502037RNORMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1436140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436140800000",
    "number": "1477936789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3007",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4310 NE KILLINGSWORTH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972181404",
            "telephone_number": "503-535-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACKLEY",
        "first_name": "JANA",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-06",
        "last_updated": "2015-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201502037RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2015; 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.