Active NPI
Kelli A Kolstad, ARNP
- Pediatric Nurse Practitioner
- Portland, OR
National Provider Identifier
1881954618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 201392700NP-PP
- Practice address
- 501 N Graham St
Suite 300
Portland, OR 97227-1654 - Phone
- (530) 400-9753
- NPI assigned
- May 27, 2012
- 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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 201392700NP-PP | OR | Primary |
| Pediatric Nurse Practitioner | 363LP0200X | AP60261020 | WA |
Addresses
Primary practice location
501 N Graham St
Suite 300
Portland, OR 97227-1654
Mailing address
501 N Graham St
Suite 300
Portland, OR 97227-1654
Phone (530) 400-9753
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201392700NP-PP | OR | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Emanuel Hospital & Health Center | Current | Accepting new patients | |
| Legacy Emanuel Hospital & Health Center | Current | Accepting new patients | |
| Legacy Emanuel Hospital & Health Center | Current | Accepting new patients |
Locations
2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200
501 N Graham St
Ste 300
Portland, OR 97227
Phone (503) 413-4300
300 N Graham St
Ste 420
Portland, OR 97227
Phone (503) 276-6138
Interoperability endpoints
- kkolstad93351@direct.lhs.org
Organizations & group practices 3
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.
-
- General Acute Care Hospital
- Portland, OR
- NPI 1831112358
-
- Community/Retail Pharmacy
- Portland, OR
- NPI 1417977976
-
- Clinic/Center
- Portland, OR
- NPI 1700809027
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384819200000",
"number": "1881954618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 N GRAHAM ST",
"address_2": "SUITE 300",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972271654",
"telephone_number": "530-400-9753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 N GRAHAM ST",
"address_2": "SUITE 300",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972271654",
"telephone_number": "530-400-9753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLSTAD",
"first_name": "KELLI",
"middle_name": "A",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-27",
"last_updated": "2013-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "OR",
"license": "201392700NP-PP",
"primary": true
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "WA",
"license": "AP60261020",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2013; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.