NPIMap

Individual provider Active NPI

Kristin Corinne Gannett, FNP

  • Family Nurse Practitioner
  • Medford, OR
National Provider Identifier
1679197982
Registry record updated Jun 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
202004201NP-PP Issued in OR
Practice address
691 Murphy Rd Ste 107
Medford, OR 97504-4311
Phone
(541) 789-6460
NPI assigned
Jun 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2020

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 202004201NP OR
Family Nurse Practitioner 363LF0000X 202004201NP-PP OR Primary

Addresses

Primary practice location

691 Murphy Rd Ste 107
Medford, OR 97504-4311

Mailing address

1360 Hillcourt St
Medford, OR 97504-6509
Phone (541) 301-0692

Other names 1

  • Kristin White Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200623002662 OR Practitioner - Nurse Practitioner 9133543663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Asante Physician PartnersGroup PAC ID 8325206246, 227 clinicians

Practice addresses (Care Compare)

691 Murphy Rd
Suite 107
Medford, OR 97504-4311
Phone (541) 789-6460

Hospital & facility affiliations

  • Accentcare Home Health of Rogue Valley, LLC Home health agency, Medford, OR, CCN 387098
  • Assured Home Health Home health agency, Grants Pass, OR, CCN 387076
  • Signature Healthcare at Home Home health agency, Central Point, OR, CCN 387142
  • Riverside Home Health Care Home health agency, Grants Pass, OR, CCN 387143
  • Asante Hospice Hospice, Talent, OR, CCN 381527
  • Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018
  • Asante Ashland Community Hospital Hospital, Ashland, OR, CCN 380005
  • Asante Three Rivers Medical Center Hospital, Grants Pass, OR, CCN 380002
  • Sky Lakes Medical Center Hospital, Klamath Falls, OR, CCN 380050

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
202004201NPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Asante Physician Partners CurrentSince Jun 18, 2020 Accepting new patients

Locations

625 SW Ramsey Ave
Ste A
Grants Pass, OR 97527
Phone (541) 474-5004

2825 E Barnett Rd
Medford, OR 97504
Phone (541) 282-6770

691 Murphy Rd
Ste 107
Medford, OR 97504
Phone (541) 789-5121

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 and National Provider Directory roles.

Hospital & facility affiliations 10

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": "1591056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591056000000",
    "number": "1679197982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 HILLCOURT ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046509",
            "telephone_number": "541-301-0692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "691 MURPHY RD STE 107",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044311",
            "telephone_number": "541-789-6460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANNETT",
        "first_name": "KRISTIN",
        "middle_name": "CORINNE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-02",
        "last_updated": "2020-06-02",
        "certification_date": "2020-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "202004201NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "202004201NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "WHITE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.