Individual provider Active NPI

Holly Nicole Weare, RD

  • Registered Dietitian
  • Lebanon, OR
National Provider Identifier
1902253164
Registry record updated May 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
10164585 Issued in OR
Practice address
525 N Santiam Hwy
Lebanon, OR 97355-4363
Phone
(541) 451-7122
Fax
(541) 451-7080
NPI assigned
May 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 10164585 OR Primary

Addresses

Primary practice location

525 N Santiam Hwy
Lebanon, OR 97355-4363

Mailing address

525 N Santiam Hwy
Lebanon, OR 97355-4363
Phone (541) 451-7122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10164585ORMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Coquille Valley Hospital District CurrentSince Mar 10, 2022 Accepting new patients
Coquille Valley Hospital District CurrentSince Mar 10, 2022 Accepting new patients

Locations

940 E 5th St
Coquille, OR 97423
Phone (541) 396-3101

790 E 5th St
Coquille, OR 97423
Phone (541) 396-3101

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/5c5c3b5c-6128-40bc-b71b-102ccb82d7e7/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463529600000",
    "number": "1902253164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 N SANTIAM HWY",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973554363",
            "telephone_number": "541-451-7122",
            "fax_number": "541-451-7080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 N SANTIAM HWY",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973554363",
            "telephone_number": "541-451-7122",
            "fax_number": "541-451-7080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEARE",
        "first_name": "HOLLY",
        "middle_name": "NICOLE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-18",
        "last_updated": "2016-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "10164585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.

Verify at the official NPI Registry.