Individual provider Active NPI

Kendra L Owens, FNP

  • Family Nurse Practitioner
  • Bend, OR
National Provider Identifier
1679905020
Registry record updated Mar 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201502470NP-PP Issued in OR
Practice address
2564 NE Courtney Dr.
Bend, OR 97701
Phone
(541) 678-5277
Fax
(541) 678-5280
NPI assigned
Aug 7, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5376 WI
Family Nurse Practitioner 363LF0000X 201502470NP-PP OR Primary

Addresses

Primary practice location

2564 NE Courtney Dr.
Bend, OR 97701

Mailing address

2564 NE Courtney Dr.
Bend, OR 97701
Phone (541) 678-5277

Other names 1

  • Kendra L Wuellner 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
I20150925002298 OR Practitioner - Nurse Practitioner 8426282955 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WFM Healthcare PCGroup PAC ID 5991993875, 5 clinicians

Practice addresses (Care Compare)

2564 NE Courtney Dr
Bend, OR 97701-7638
Phone (541) 678-5277

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5376WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
WFM Healthcare, P.C. CurrentSince Aug 1, 2015 Accepting new patients
Paulina Peak Family Healthcare Inc Family Past Accepting new patients

Locations

2564 NE Courtney Dr
Bend, OR 97701
Phone (541) 678-5277

Interoperability endpoints

  • Direct secure messaging: kowens24419@coipa.gardenplot.direct-ci.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1375833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519948800000",
    "number": "1679905020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2564 NE COURTNEY DR.",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97701",
            "telephone_number": "541-678-5277",
            "fax_number": "541-678-5280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2564 NE COURTNEY DR.",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97701",
            "telephone_number": "541-678-5277",
            "fax_number": "541-678-5280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENS",
        "first_name": "KENDRA",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-07",
        "last_updated": "2018-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "5376",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201502470NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENDRA",
            "last_name": "WUELLNER",
            "middle_name": "L",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.