Active NPI
Abby Ehntholt, N.P.
- Family Nurse Practitioner
- Bend, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 33340757
- Practice address
- 2195 NW Shevlin Park Rd Ste 100
Bend, OR 97703-7102 - Phone
- (541) 706-3819
- Fax
- (541) 429-6659
- NPI assigned
- Aug 11, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 101.0114340 | VT | |
| Family Nurse Practitioner | 363LF0000X | 33340757 | NY | Primary |
Addresses
Primary practice location
2195 NW Shevlin Park Rd Ste 100
Bend, OR 97703-7102
Mailing address
PO Box 1517
Pendleton, OR 97801-0410
Phone (877) 708-1119
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA, OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
815 SW Bond St
Suite 100
Bend, OR 97702-3593
Phone (541) 706-2525
Hospital & facility affiliations
- St Charles Medical Center - Bend
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33340757 | NY | MD | Family Nurse Practitioner |
| 101.0114340 | VT | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bend Memorial Clinic PC | Current | Accepting new patients | |
| Signify Health Medical Associates, PLLC | Current | Accepting new patients | |
| Schweiger Dermatology PLLC | Current | Accepting new patients | |
| Bend Memorial Clinic PC | Family | Current | Accepting new patients |
Locations
333 Hooper Rd
Endwell, NY 13760
Phone (607) 729-2776
1501 NE Medical Center Dr
Bend, OR 97701
Phone (541) 317-4354
815 SW Bond St
#100
Bend, OR 97702
Phone (541) 706-2525
815 SW Bond St
Bend, OR 97702
Phone (541) 382-4900
780 Commercial St SE
Ste 100
Salem, OR 97301
Phone (469) 466-7037
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
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 and National Provider Directory roles.
-
- Family Medicine Physician
- Bend, OR
- NPI 1699827477
-
- Clinical Medical Laboratory
- Bend, OR
- NPI 1972144913
-
- Dermatology Physician
- New York, NY
- NPI 1831438662
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Sleep Disorder Diagnostic Clinic/Center
- Bend, OR
- NPI 1164675963
Hospital
-
- General Acute Care Hospital
- Bend, OR
- NPI 1982621447
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630368000000",
"number": "1871969022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1517",
"city": "PENDLETON",
"state": "OR",
"postal_code": "978010410",
"telephone_number": "877-708-1119",
"fax_number": "541-278-8349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2195 NW SHEVLIN PARK RD STE 100",
"city": "BEND",
"state": "OR",
"postal_code": "977037102",
"telephone_number": "541-706-3819",
"fax_number": "541-429-6659"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EHNTHOLT",
"first_name": "ABBY",
"name_prefix": "Ms.",
"credential": "N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-11",
"last_updated": "2021-08-31",
"certification_date": "2021-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "VT",
"license": "101.0114340",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "33340757",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.