Individual provider Active NPI

Kristine Marie Dillon, PNP

  • Pediatric Nurse Practitioner
  • Oregon City, OR
National Provider Identifier
1689865271
Registry record updated Aug 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
077039035N2 Issued in OR
Practice address
1510 Division St
Suite 280
Oregon City, OR 97045-1581
Phone
(503) 905-3400
Fax
(503) 905-3399
NPI assigned
Aug 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 077039035N2 OR Primary

Addresses

Primary practice location

1510 Division St
Suite 280
Oregon City, OR 97045-1581

Mailing address

21515 SW Ramblin Reck Rd
Sherwood, OR 97140-9613
Phone (503) 625-6930

Other identifiers 1

IdentifierTypeStateIssuer
070222MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
077039035N2ORMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186444800000",
    "number": "1689865271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21515 SW RAMBLIN RECK RD",
            "city": "SHERWOOD",
            "state": "OR",
            "postal_code": "971409613",
            "telephone_number": "503-625-6930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 DIVISION ST",
            "address_2": "SUITE 280",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970451581",
            "telephone_number": "503-905-3400",
            "fax_number": "503-905-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLON",
        "first_name": "KRISTINE",
        "middle_name": "MARIE",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-07",
        "last_updated": "2007-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OR",
            "license": "077039035N2",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070222",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.