Individual provider Active NPI

Angeleic Kennemer

  • Addiction (Substance Use Disorder) Registered Nurse
  • Saint Helens, OR
National Provider Identifier
1932596632
Registry record updated Apr 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X
License
201402811RN Issued in OR
Practice address
185 N 4TH St
Saint Helens, OR 97051-1535
Phone
(503) 366-4540
NPI assigned
Apr 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 201402811RN OR Primary

Addresses

Primary practice location

185 N 4TH St
Saint Helens, OR 97051-1535

Mailing address

185 N 4TH St
Saint Helens, OR 97051-1535
Phone (503) 366-4540

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
201402811RNORMDAddiction (Substance Use Disorder) Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1429488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429488000000",
    "number": "1932596632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 N 4TH ST",
            "city": "SAINT HELENS",
            "state": "OR",
            "postal_code": "970511535",
            "telephone_number": "503-366-4540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 N 4TH ST",
            "city": "SAINT HELENS",
            "state": "OR",
            "postal_code": "970511535",
            "telephone_number": "503-366-4540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEMER",
        "first_name": "ANGELEIC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-20",
        "last_updated": "2015-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "201402811RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Helens, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; 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.