Active NPI
Hollie Rynerson Kaufman, ARNP
- Family Nurse Practitioner
- Port Angeles, WA
National Provider Identifier
1518056357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP30007743
- 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, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8867595 | Other | WA | MEDICARE ID |
| 00421026 | Other | WA | RAILROAD MEDICARE |
| 0222708 | Other | WA | LABOR AND INDUSTRIES |
| K33667 | Other | PROVIDER NUMBER | |
| 9653577 | Medicaid | WA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 209-006133 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McLean County Orthopedics, LTD | Past | Accepting new patients |
Interoperability endpoints
- 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.
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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.