Kathleen Siebe, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

78040158 Issued in OR

Practice address

603 Medical Parkway
Enterprise, OR 97828-1168

Phone

(541) 426-4502

Fax

(541) 426-6403

NPI assigned

Aug 23, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: ksiebe24748@direct.ochin.org

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381449600000",
    "number": "1750374021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 MEDICAL PARKWAY",
            "city": "ENTERPRISE",
            "state": "OR",
            "postal_code": "978281168",
            "telephone_number": "541-426-4502",
            "fax_number": "541-426-6403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 MEDICAL PARKWAY",
            "city": "ENTERPRISE",
            "state": "OR",
            "postal_code": "978281168",
            "telephone_number": "541-426-4502",
            "fax_number": "541-426-6403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEBE",
        "first_name": "KATHLEEN",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-23",
        "last_updated": "2013-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OR",
            "license": "78040158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5966003",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFIC SOURCE",
            "identifier": "J054904",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "267989",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susanna Naomi Schauffler
• Vena Marie Schexnayder
• Allen Schnetzky
• Emily A Sheahan, MD
• Ebony Leree Shorts, LCSW
• Scott K Siebe, MD
• Jessica L Skillings
• Landra Kaia Skovlin, LMT
• Glenn Smith
• Erna Andrea Solheim, LMSW

• Pediatric Nurse Practitioner in Enterprise, OR
• Providers in Enterprise, OR by specialty
• Pediatric Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2013; 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.