Individual provider Active NPI

Amy Owens Kenagy, NP

  • Pediatric Nurse Practitioner
  • Portland, OR
National Provider Identifier
1568407633
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
Practice address
3181 SW Sam Jackson Park Rd
Uhs-2
Portland, OR 97239-3011
Phone
(503) 494-4910
Fax
(503) 494-8368
NPI assigned
Jun 20, 2006
Last updated
Jul 16, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
Uhs-2
Portland, OR 97239-3011

Mailing address

3181 SW Sam Jackson Park Rd
Uhs-2
Portland, OR 97239-3011
Phone (503) 494-4910

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
I20050414001266 OR Practitioner - Nurse Practitioner 8123065638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200450052NPORMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Jan 1, 2009 Accepting new patients
University Professional Services CurrentSince Jan 1, 2009 Accepting new patients
University Professional Services Current Accepting new patients
University Anesthesiology Associates LLC Past Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

3181 SW Sam Jackson Park Rd
#2
Portland, OR 97239
Phone (503) 494-4910

Interoperability endpoints

  • Direct secure messaging: akenagynp12354@direct.ohsu.edu

Organizations & group practices 4

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1568407633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "UHS-2",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-4910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "UHS-2",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-4910",
            "fax_number": "503-494-8368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENAGY",
        "first_name": "AMY",
        "middle_name": "OWENS",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.