Courtney Joy Kennison, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

201508511NP-PP Issued in OR

Practice address

734 Elm St SW
Albany, OR 97321-1934

Phone

(541) 812-5111

NPI assigned

Nov 8, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ckennison286896@samhealth.direct-ci.com
• Direct secure messaging: ckennison196730@samhealth.direct-ci.com

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.

• Albany General Hospital

  dba Samaritan Albany General Hospital

  • General Acute Care Hospital
  • Albany, OR
  • NPI 1154372340
  Medicare reassignment NPD
• Good Samaritan Hospital Corvallis

  dba Good Samaritan Regional Medical Center

  • General Acute Care Hospital
  • Corvallis, OR
  • NPI 1962453134
  Medicare reassignment NPD
• Mid-Valley Healthcare Inc

  dba Samaritan Lebanon Community Hospital

  • Critical Access Hospital
  • Lebanon, OR
  • NPI 1689625980
  Medicare reassignment NPD
• Albany General Hospital

  dba Samaritan InterCommunity Health Clinic - Albany

  • Family Medicine Physician
  • Albany, OR
  • NPI 1306679816
  NPD
• Albany General Hospital

  dba Samaritan Health Clinic - North Albany

  • Family Medicine Physician
  • Albany, OR
  • NPI 1740546431
  NPD
• Good Samaritan Hospital Corvallis

  dba Samaritan Breast, Reconstruction & Surgical Oncology

  • Plastic Surgery Physician
  • Corvallis, OR
  • NPI 1205192457
  NPD
• Good Samaritan Hospital Corvallis

  dba Samaritan Gynecologic Oncology - Corvallis

  • Gynecologic Oncology Physician
  • Corvallis, OR
  • NPI 1710787916
  NPD
• Mid-Valley Healthcare Inc

  dba Samaritan Outpatient Treatment & Recovery Services - Newport

  • Addiction Medicine (Internal Medicine) Physician
  • Newport, OR
  • NPI 1740087899
  NPD
• Mid-Valley Healthcare, Inc.

  dba SamCare Mobile Medical

  • Family Medicine Physician
  • Halsey, OR
  • NPI 1427406248
  NPD

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

{
    "created_epoch": "1446940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1982077251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "734 ELM ST SW",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211934",
            "telephone_number": "541-812-5111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "891 23rd St NE",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973011793",
            "country_code": "US",
            "telephone_number": "503-364-2181",
            "fax_number": "503-364-0364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNISON",
        "first_name": "COURTNEY",
        "middle_name": "JOY",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-08",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OR",
            "license": "201508511NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ckennison196730@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "734 Elm St SW",
            "city": "Albany",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973211934",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Norma Kehdi Kehdi
• Michael B Kelty
• Jessica Kempken
• Abigail Townsend Kennedy, M.D.
• Gabriel M Kennedy, DMD
• Ronald Kerlee
• Kevin C Kern
• Eric William Kerstetter, DPT
• Suzanne Kesterson, M.A., CCC-SLP
• Vallery A. Kesterson, BC-HIS

• Pediatric Nurse Practitioner in Albany, OR
• Providers in Albany, OR by specialty
• Pediatric Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.