Individual provider Active NPI

Kara E Stiles, ANP

  • Adult Health Nurse Practitioner
  • Medford, OR
National Provider Identifier
1700199478
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
CNP-02908 Issued in NM
Practice address
3617 S Pacific Hwy
Medford, OR 97501-8957
Phone
(541) 535-6239
Fax
(541) 512-1029
NPI assigned
Jul 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN-83725 NM
Adult Health Nurse Practitioner 363LA2200X CNP-02908 NM Primary

Addresses

Primary practice location

3617 S Pacific Hwy
Medford, OR 97501-8957

Mailing address

5608 Zuni Rd SE
Albuquerque, NM 87108-2926
Phone (505) 262-2481

Other practice location 1

730 Saint Michaels Dr Ste 4B
Santa Fe, NM 87505-7606
Phone (505) 982-3684

Other identifiers 1

IdentifierTypeStateIssuer
23454318MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20160627000900 NM Practitioner - Nurse Practitioner 4082844667 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN-83725NMMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Jul 1, 2016 Accepting new patients
Presbyterian Healthcare Services CurrentSince Jul 1, 2016 Accepting new patients
Unm Medical Group, Inc. CurrentSince Apr 16, 2020 Accepting new patients
Unm Medical Group Inc CurrentSince Apr 16, 2020 Accepting new patients

Locations

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

Organizations & group practices 4

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": "1279756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1700199478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5608 ZUNI RD SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871082926",
            "telephone_number": "505-262-2481",
            "fax_number": "505-265-7045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3617 S PACIFIC HWY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975018957",
            "telephone_number": "541-535-6239",
            "fax_number": "541-512-1029"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "730 Saint Michaels Dr Ste 4B",
            "address_purpose": "LOCATION",
            "city": "Santa Fe",
            "state": "NM",
            "postal_code": "875057606",
            "country_code": "US",
            "telephone_number": "505-982-3684",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STILES",
        "first_name": "KARA",
        "middle_name": "E",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-22",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NM",
            "license": "RN-83725",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NM",
            "license": "CNP-02908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23454318",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.