NPIMap

Individual provider Active NPI

Kristin Donnelly, APNP

  • Family Nurse Practitioner
  • Bend, OR
National Provider Identifier
1932875002
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10051697 Issued in OR
Practice address
2165 NW Shevlin Park Rd
Bend, OR 97703-7101
Phone
(541) 317-5600
Fax
(541) 317-5676
NPI assigned
Aug 19, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 10051697 OR Primary

Addresses

Primary practice location

2165 NW Shevlin Park Rd
Bend, OR 97703-7101

Mailing address

PO Box 1517
Pendleton, OR 97801-0410
Phone (877) 708-1119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210909001645 WI Practitioner - Nurse Practitioner 4587060918
I20260204000910 OR Practitioner - Nurse Practitioner 4587060918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Praxis Health PCGroup PAC ID 8325941446, 174 clinicians

Practice addresses (Care Compare)

2165 NW Shevlin Park Rd
Bend, OR 97703-7101
Phone (541) 389-7741

Hospital & facility affiliations

  • St Vincent Hospital Hospital, Green Bay, WI, CCN 520075
  • St Charles Medical Center - Bend Hospital, Bend, OR, CCN 380047
  • HSHS St Clare Memorial Hospital Hospital, Oconto Falls, WI, CCN 521310
  • St Nicholas Hospital Hospital, Sheboygan, WI, CCN 520044
  • St Charles Madras Hospital, Madras, OR, CCN 381324

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11230WIMDPharmacist
10051697ORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Current Accepting new patients
St Mary'S Hospital Medical Center of Green Bay Inc.-Hospital Sisters CurrentSince Aug 1, 2021 Accepting new patients
Praxis Health, PC CurrentSince Feb 2, 2026 Accepting new patients
Praxis Health, PC Family CurrentSince Feb 2, 2026 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Aug 1, 2021 Accepting new patients
St. Vincent Hospital-Hospital Sisters-Third Order of St. Francis CurrentSince Aug 1, 2021 Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Aug 1, 2021 Accepting new patients

Locations

2165 NW Shevlin Park Rd
Bend, OR 97703
Phone (541) 317-5600

2165 NW Shevlin Park Rd
Ste Endo
Bend, OR 97703

1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

855 S Main St
Ste 1
Oconto Falls, WI 54154
Phone (920) 846-8187

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

Organizations & group practices 7

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1629331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1932875002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1517",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978010410",
            "telephone_number": "877-708-1119",
            "fax_number": "541-278-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2165 NW SHEVLIN PARK RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977037101",
            "telephone_number": "541-317-5600",
            "fax_number": "541-317-5676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "KRISTIN",
        "credential": "APNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-19",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "10051697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.