Individual provider Active NPI

Molly Elizabeth Yao, FNP

  • Family Nurse Practitioner
  • Stayton, OR
National Provider Identifier
1619568219
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
202100649NP-PP Issued in OR
Practice address
1377 N 10TH Ave
Stayton, OR 97383-2037
Phone
(503) 769-8470
Fax
(503) 769-9860
NPI assigned
Jan 27, 2021
Last updated
Jan 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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 202100649NP-PP OR Primary
Registered Nurse 163W00000X 201810173RN OR

Addresses

Primary practice location

1377 N 10TH Ave
Stayton, OR 97383-2037

Mailing address

1377 N 10TH Ave
Stayton, OR 97383-2037
Phone (503) 769-8470

Other identifiers 1

IdentifierTypeStateIssuer
500790547MedicaidOR

Other names 1

  • Molly Elizabeth Holway Former name

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
I20210309001464 OR Practitioner - Nurse Practitioner 6204242746 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Santiam Memorial HospitalGroup PAC ID 6103729751, 128 clinicians

Practice addresses (Care Compare)

1369 N 10TH Ave
Stayton, OR 97383-2037
Phone (503) 769-8470

1371 N 10TH Ave
Stayton, OR 97383-2037
Phone (503) 769-3785

1373 N 10TH Ave
Stayton, OR 97383-2037
Phone (503) 769-9522

1375 N 10TH Ave
Suite B
Stayton, OR 97383-2099
Phone (503) 769-7546

1401 N 10TH Ave
Stayton, OR 97383-1311
Phone (503) 769-2175

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Santiam Memorial Hospital Current Accepting new patients
Santiam Memorial Hospital CurrentSince May 1, 2023 Accepting new patients
Santiam Memorial Hospital CurrentSince May 1, 2023 Accepting new patients
Santiam Memorial Hospital Past Accepting new patients

Locations

1375 N 10th Ave
Ste B
Stayton, OR 97383
Phone (503) 769-7546

1377 N 10th Ave
Stayton, OR 97383
Phone (503) 769-7771

Organizations & group practices 5

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": "1611705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1619568219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1377 N 10TH AVE",
            "city": "STAYTON",
            "state": "OR",
            "postal_code": "973832037",
            "telephone_number": "503-769-8470",
            "fax_number": "503-769-9860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1377 N 10TH AVE",
            "city": "STAYTON",
            "state": "OR",
            "postal_code": "973832037",
            "telephone_number": "503-769-8470",
            "fax_number": "503-769-9860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAO",
        "first_name": "MOLLY",
        "middle_name": "ELIZABETH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-27",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "202100649NP-PP",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201810173RN",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500790547",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "HOLWAY",
            "middle_name": "ELIZABETH",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stayton, OR

Sources for this page

Verify at the official NPI Registry.