Individual provider Active NPI

Jueth Atigbi-Hansen, FNP

  • Family Nurse Practitioner
  • Klamath Falls, OR
National Provider Identifier
1588064596
Registry record updated Dec 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201703946NP-PP Issued in OR
Practice address
2340 S 6TH St
Klamath Falls, OR 97601-4340
Phone
(541) 204-4493
Fax
(541) 291-9825
NPI assigned
Aug 27, 2014
Last updated
Dec 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2021

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 201703946NP-PP OR Primary
Family Nurse Practitioner 363LF0000X RN194301 GA

Addresses

Primary practice location

2340 S 6TH St
Klamath Falls, OR 97601-4340

Mailing address

2340 S 6TH St
Klamath Falls, OR 97601-4340
Phone (541) 204-4493

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20141016002697 GA Practitioner - Nurse Practitioner 6800017872 Reassigns benefits to 1 organization
I20170909000051 OR Practitioner - Nurse Practitioner 6800017872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nisha Jackson IncGroup PAC ID 6305147745, 47 clinicians

Practice addresses (Care Compare)

2340 S 6TH St
Klamath Falls, OR 97601-4340
Phone (541) 851-2107

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201703946NP-PPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ac Spine & Wellness Center LLC CurrentSince Jun 1, 2016 Accepting new patients

Locations

217 Scenic Hwy
Lawrenceville, GA 30046
Phone (770) 513-6565

217 Scenic Hwy
#124
Lawrenceville, GA 30046
Phone (770) 513-8922

Interoperability endpoints

  • Direct secure messaging: jueth.atigbihansen.p1@direct.opm.nextgenshare.com

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639094400000",
    "number": "1588064596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2340 S 6TH ST",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976014340",
            "telephone_number": "541-204-4493",
            "fax_number": "541-291-9825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2340 S 6TH ST",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976014340",
            "telephone_number": "541-204-4493",
            "fax_number": "541-291-9825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATIGBI-HANSEN",
        "first_name": "JUETH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-27",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201703946NP-PP",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN194301",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Klamath Falls, OR

Sources for this page

Verify at the official NPI Registry.