Individual provider Active NPI

Patricia K Kenyon

  • Registered Nurse
  • Corvallis, OR
National Provider Identifier
1922394063
Registry record updated Jun 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
93-6001786 Issued in OR
Practice address
201 Plageman BLDG
Corvallis, OR 97331-8567
Phone
(541) 737-9355
Fax
(541) 737-9695
NPI assigned
Jun 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 93-6001786 OR Primary

Addresses

Primary practice location

201 Plageman BLDG
Corvallis, OR 97331-8567

Mailing address

2773 NW Skyline Dr
Corvallis, OR 97330-3167

Other identifiers 1

IdentifierTypeStateIssuer
93-6001786OtherOROUS

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
93-6001786ORMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309219200000",
    "number": "1922394063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2773 NW SKYLINE DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PLAGEMAN BLDG",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973318567",
            "telephone_number": "541-737-9355",
            "fax_number": "541-737-9695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENYON",
        "first_name": "PATRICIA",
        "middle_name": "K",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-28",
        "last_updated": "2011-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "93-6001786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OUS",
            "identifier": "93-6001786",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.