Individual provider Active NPI

Kelly Peeler

  • Registered Nurse
  • Portland, OR
National Provider Identifier
1932065810
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
201403836 Issued in OR
Practice address
1211 NE 58TH Ave
Portland, OR 97213-3625
Phone
(503) 789-5415
NPI assigned
Jan 5, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

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 201403836 OR Primary

Addresses

Primary practice location

1211 NE 58TH Ave
Portland, OR 97213-3625

Mailing address

1211 NE 58TH Ave
Portland, OR 97213-3625
Phone (503) 789-5415

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
201403836ORMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1767571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1932065810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 NE 58TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972133625",
            "telephone_number": "503-789-5415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 NE 58TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972133625",
            "telephone_number": "503-789-5415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEELER",
        "first_name": "KELLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-05",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201403836",
            "primary": true
        }
    ],
    "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 Jan 5, 2026; 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.