Individual provider Active NPI

Hollie Rynerson Kaufman, ARNP

  • Family Nurse Practitioner
  • Port Angeles, WA
National Provider Identifier
1518056357
Registry record updated Sep 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP30007743 Issued in WA
Practice address
243511 West Hwy 101
Port Angeles, WA 98363-9472
Phone
(360) 452-6252
Fax
(360) 452-6274
NPI assigned
Oct 12, 2006
Last updated
Sep 4, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209-006133 IL
Family Nurse Practitioner 363LF0000X AP30007743 WA Primary

Addresses

Primary practice location

243511 West Hwy 101
Port Angeles, WA 98363-9472

Mailing address

243511 West Hwy 101
Port Angeles, WA 98363-9472
Phone (360) 452-6252

Other identifiers 5

IdentifierTypeStateIssuer
8867595OtherWAMEDICARE ID
00421026OtherWARAILROAD MEDICARE
0222708OtherWALABOR AND INDUSTRIES
K33667OtherPROVIDER NUMBER
9653577MedicaidWA

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
209-006133ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
McLean County Orthopedics, LTD Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/491/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346716800000",
    "number": "1518056357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243511 WEST HWY 101",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983639472",
            "telephone_number": "360-452-6252",
            "fax_number": "360-452-6274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243511 WEST HWY 101",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983639472",
            "telephone_number": "360-452-6252",
            "fax_number": "360-452-6274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFMAN",
        "first_name": "HOLLIE",
        "middle_name": "RYNERSON",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2012-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209-006133",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30007743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "8867595",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "00421026",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0222708",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "K33667",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9653577",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Angeles, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2012; 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.