Individual provider Active NPI

Dawn Nadine Warddrip, P.N.P.

  • Pediatric Nurse Practitioner
  • Hillsboro, OR
National Provider Identifier
1871580217
Registry record updated Jun 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
200050085 Issued in OR
Practice address
445 E Main St
Hillsboro, OR 97123-4084
Phone
(503) 640-2757
Fax
(503) 640-9753
NPI assigned
Sep 30, 2005
Last updated
Jun 15, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 200050085 OR Primary

Addresses

Primary practice location

445 E Main St
Hillsboro, OR 97123-4084

Mailing address

445 E Main St
Hillsboro, OR 97123-4084
Phone (503) 640-2757

Other identifiers 2

IdentifierTypeStateIssuer
R167203OtherPTAN
000459MedicaidOR

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
I20121205000106 OR Practitioner - Nurse Practitioner 8820240484 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200050085ORMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hillsboro Pediatric Clinic LLC CurrentSince Aug 31, 2012 Accepting new patients

Locations

445 E Main St
Hillsboro, OR 97123
Phone (503) 640-2757

445 E Main St
Ste 100
Hillsboro, OR 97123
Phone (503) 640-3147

6125 NE Cornell Rd
Ste 240
Hillsboro, OR 97124
Phone (503) 640-2757

Interoperability endpoints

  • Direct secure messaging: wwarddrip@hpc.ssdirect.aprima.com

Organizations & group practices 1

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": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497484800000",
    "number": "1871580217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 E MAIN ST",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971234084",
            "telephone_number": "503-640-2757",
            "fax_number": "503-640-9753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 E MAIN ST",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971234084",
            "telephone_number": "503-640-2757",
            "fax_number": "503-640-9753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARDDRIP",
        "first_name": "DAWN",
        "middle_name": "NADINE",
        "credential": "P.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-30",
        "last_updated": "2017-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OR",
            "license": "200050085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "R167203",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000459",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

Verify at the official NPI Registry.