Individual provider Active NPI

Paul Kohn, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
National Provider Identifier
1508917915
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
000035487N6 Issued in OR
Practice address
1962 NW Kearney St
Suite 206
Portland, OR 97209-1400
Phone
(503) 221-8707
NPI assigned
Jan 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 Nurse Practitioner 363LP0808X 000035487N6 OR Primary

Addresses

Primary practice location

1962 NW Kearney St
Suite 206
Portland, OR 97209-1400

Mailing address

1962 NW Kearney St
Suite 206
Portland, OR 97209-1400

Other identifiers 1

IdentifierTypeStateIssuer
044482MedicaidOR

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
I20120413000161 OR Practitioner - Nurse Practitioner 5799946307 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1962 NW Kearney St
Suite 206
Portland, OR 97209-1464
Phone (503) 221-8707

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kohn, Inc Psychiatric/Mental Health CurrentSince Feb 27, 2012 Accepting new patients

Locations

1962 NW Kearney St
Ste 206
Portland, OR 97209
Phone (503) 221-8707

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.

NPI Registry JSON

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

{
    "created_epoch": "1168646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508917915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1962 NW KEARNEY ST",
            "address_2": "SUITE 206",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972091400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1962 NW KEARNEY ST",
            "address_2": "SUITE 206",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972091400",
            "telephone_number": "503-221-8707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHN",
        "first_name": "PAUL",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "000035487N6",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044482",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.