Individual provider Active NPI

Nancy Lee Wernecke, PMHNP

  • Psychiatric/Mental Health Registered Nurse
  • Lake Oswego, OR
National Provider Identifier
1497894356
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
Practice address
9 Monroe Pkwy
Suite 280
Lake Oswego, OR 97035-1495
Phone
(503) 699-8550
Fax
(503) 635-8411
NPI assigned
Feb 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X OR Primary

Addresses

Primary practice location

9 Monroe Pkwy
Suite 280
Lake Oswego, OR 97035-1495

Mailing address

9 Monroe Parkway
Suite 280
Lake Oswego, OR 97035-8867
Phone (503) 699-8550

Other identifiers 1

IdentifierTypeStateIssuer
120431MedicaidOR

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

LicenseStateTypeSpecialty
86-007025N6ORMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Kendra J. Summers, PHD Past Accepting new patients
Family Crossroads Inc. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1497894356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 MONROE PARKWAY",
            "address_2": "SUITE 280",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970358867",
            "telephone_number": "503-699-8550",
            "fax_number": "503-635-8411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 MONROE PKWY",
            "address_2": "SUITE 280",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970351495",
            "telephone_number": "503-699-8550",
            "fax_number": "503-635-8411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERNECKE",
        "first_name": "NANCY",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120431",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.