Erin Arnold Bishop, ARNP-BC
Individual provider Active NPI Nurse Practitioner · Bend, OR
NPI 1720165541 · NPPES record last updated Mar 17, 2018
Key facts
- NPI
- 1720165541
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 9196869 (FL)
- Practice address
- 155 SW Century Dr Ste 111
Bend, OR 97702-1657 - Phone
- (458) 206-3331
- Fax
- (620) 506-4777
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2018 through Jan 1, 2028
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9196869 | FL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vitality Functional Medicine LLC | Current | Accepting new patients | |
| Boca Medical Specialists, Inc | Past | Accepting new patients |
Locations
155 SW Century Dr
Ste 111
Bend, OR 97702
Phone (541) 789-7622
151 SW Shevlin Hixon Dr
Ste 101
Bend, OR 97702
Phone (541) 248-1577
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 9196869 | FL | Yes |
Addresses
Primary practice location
155 SW Century Dr Ste 111
Bend, OR 97702-1657
Mailing address
19657 Aspen Ridge Dr
Bend, OR 97702-3366
Phone (561) 676-6121
Other practice location 1
19657 Aspen Ridge Dr
Bend, OR 97702-3366
Phone (561) 676-6121
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9196869 | Other | FL | ARNP |
Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.