Individual provider Active NPI

Khuelien Nguyen Dretke, NP

  • Family Nurse Practitioner
  • Bend, OR
National Provider Identifier
1831130251
Registry record updated Oct 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
93006637 Issued in OR
Practice address
929 SW Simpson Ave
Suite 300
Bend, OR 97702-3599
Phone
(541) 389-7741
Fax
(541) 278-8375
NPI assigned
Jun 9, 2006
Last updated
Oct 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 93006637 OR Primary

Addresses

Primary practice location

929 SW Simpson Ave
Suite 300
Bend, OR 97702-3599

Mailing address

PO Box 670
Bend, OR 97709-0670
Phone (541) 389-7741

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kdretke1751677@oc.providencedirect.org

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
I20040515000329 OR Practitioner - Nurse Practitioner 4284624800 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salem HealthGroup PAC ID 8628986668, 470 clinicians

Practice addresses (Care Compare)

1002 Bellevue St SE
Salem, OR 97301-4006
Phone (503) 561-5437

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
93006637ORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Health CurrentSince Nov 21, 2022 Accepting new patients
Salem Health Current Accepting new patients
Salem Health West Valley CurrentSince Nov 21, 2022 Accepting new patients
Salem Health CurrentSince Nov 21, 2022 Accepting new patients
Bend Memorial Clinic PC CurrentSince Sep 1, 2018 Accepting new patients
Bend Memorial Clinic PC Family CurrentSince Sep 1, 2018 Accepting new patients
Mt. Emily Medical Associates, LLC Past Accepting new patients

Locations

1501 NE Medical Center Dr
Bend, OR 97701
Phone (541) 317-4354

815 SW Bond St
#100
Bend, OR 97702
Phone (541) 706-2525

1601 Monmouth St
Ste 100
Independence, OR 97351
Phone (503) 623-8301

665 Winter St SE
Salem, OR 97301
Phone (503) 370-5634

1002 Bellevue St SE
Salem, OR 97301
Phone (503) 561-5554

Interoperability endpoints

  • Direct secure messaging: kdretke1751677@oc.providencedirect.org
  • Direct secure messaging: kdretke343669@direct.salemhealth.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1831130251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 670",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977090670",
            "telephone_number": "541-389-7741",
            "fax_number": "541-278-8375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 SW SIMPSON AVE",
            "address_2": "SUITE 300",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023599",
            "telephone_number": "541-389-7741",
            "fax_number": "541-278-8375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRETKE",
        "first_name": "KHUELIEN",
        "middle_name": "NGUYEN",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "93006637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kdretke1751677@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "11995 SE Sunnyside Rd",
            "city": "Happy Valley",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970159312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.