Nicole Hainley, AGACNP, FNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

201150145NP Issued in OR

Practice address

9205 SW Barnes Rd
Portland, OR 97225-6603

Phone

(503) 215-2906

NPI assigned

Feb 2, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services - OregonGroup PAC ID 9335057447, 212 clinicians

Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nhainley114337@oc.providencedirect.org

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.

• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1114015971
  Medicare reassignment Care Compare group NPD
• Providence Health & Services Oregon

  • General Practice Physician
  • Lake Oswego, OR
  • NPI 1023488343
  Medicare reassignment Care Compare group NPD
• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1003991845
  Medicare reassignment NPD
• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Oregon City, OR
  • NPI 1912282369
  Medicare reassignment NPD
• Tuality Medical Group LLC

  • Internal Medicine Physician
  • Hillsboro, OR
  • NPI 1073929782
  Medicare reassignment NPD
• Providence Health & Services - Oregon

  • Clinical Pathology Physician
  • Oregon City, OR
  • NPI 1003368911
  NPD
• Providence Health & Services - Oregon

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Portland, OR
  • NPI 1396019451
  NPD
• Providence Health & Services - Oregon

  • Clinical Pathology Physician
  • Portland, OR
  • NPI 1831641745
  NPD
• Providence Health & Services Oregon

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Portland, OR
  • NPI 1396818993
  NPD
• Providence Health & Services Oregon

  • Psychiatry Physician
  • Portland, OR
  • NPI 1760177737
  NPD
• Tuality Medical Group LLC

  • Neurology Physician
  • Hillsboro, OR
  • NPI 1639690704
  NPD

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

• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1114015971
  Care Compare affiliation

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

{
    "created_epoch": "1296604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1609172006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9205 SW BARNES RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256603",
            "telephone_number": "503-215-2906"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9155 SW Barnes Rd",
            "address_2": "Suite 420",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972256625",
            "country_code": "US",
            "telephone_number": "503-297-6334",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAINLEY",
        "first_name": "NICOLE",
        "credential": "AGACNP, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-02",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "201150145NP",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OR",
            "license": "201150145NP",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OR",
            "license": "201809639NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201150145NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "336624",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OR",
            "license": "201150145NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nhainley114337@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9205 SW Barnes Rd",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972256603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Scott David Haines, DC, BFA, AAS
• Susan Mawdesley Haines, MS, CDS III, NCGC II
• Daniel Hainley
• Kathryn Hainley, MSW
• Leocadia Hainley
• Breauna Hair, RN
• Michelle A Hairgrove, QMHP-C
• Christina Marie Haiser, P.T.
• Nadeen Nazem Hajaj, DNP, PMHNP-BC
• Tamar Hajar, MD

• Gerontology Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Gerontology Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.