Individual provider Active NPI

Kailey Anne Christison

  • Physician Assistant
  • Stayton, OR
National Provider Identifier
1861153942
Registry record updated Apr 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1371 N 10TH Ave
Stayton, OR 97383-2037
Phone
(503) 769-3785
Fax
(503) 769-3741
NPI assigned
Dec 31, 2021
Last updated
Apr 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1371 N 10TH Ave
Stayton, OR 97383-2037

Mailing address

1371 N 10TH Ave
Stayton, OR 97383-2037
Phone (503) 769-3785

Other practice location 1

6944 Liberty Rd S
Salem, OR 97306-9512
Phone (503) 580-0776

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kailey.christison.1@14369.direct.athenahealth.com

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
I20220420002180 OR Practitioner - Physician Assistant 7012304173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Santiam Memorial HospitalGroup PAC ID 6103729751, 128 clinicians

Practice addresses (Care Compare)

1369 N 10TH Ave
Stayton, OR 97383-2037
Phone (503) 769-8470

1371 N 10TH Ave
Stayton, OR 97383-2037
Phone (503) 769-3785

1373 N 10TH Ave
Stayton, OR 97383-2037
Phone (503) 769-9522

1375 N 10TH Ave
Suite B
Stayton, OR 97383-2099
Phone (503) 769-7546

1401 N 10TH Ave
Stayton, OR 97383-1311
Phone (503) 769-2175

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Santiam Memorial Hospital CurrentSince Apr 11, 2022 Accepting new patients
Santiam Memorial Hospital CurrentSince Apr 11, 2022 Accepting new patients
Santiam Memorial Hospital Past Accepting new patients
Santiam Memorial Hospital Past Accepting new patients

Locations

1371 N 10th Ave
Stayton, OR 97383
Phone (503) 769-1605

1375 N 10th Ave
Ste B
Stayton, OR 97383
Phone (503) 769-7546

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1640908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650844800000",
    "number": "1861153942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1371 N 10TH AVE",
            "city": "STAYTON",
            "state": "OR",
            "postal_code": "973832037",
            "telephone_number": "503-769-3785",
            "fax_number": "503-769-3741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1371 N 10TH AVE",
            "city": "STAYTON",
            "state": "OR",
            "postal_code": "973832037",
            "telephone_number": "503-769-3785",
            "fax_number": "503-769-3741"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6944 Liberty Rd S",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973069512",
            "country_code": "US",
            "telephone_number": "503-580-0776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHRISTISON",
        "first_name": "KAILEY",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-31",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kailey.christison.1@14369.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "1371 N 10th Ave",
            "city": "Stayton",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973832037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stayton, OR

Sources for this page

Verify at the official NPI Registry.