Individual provider Active NPI

Julie Rendon, AGACNP

  • Acute Care Nurse Practitioner
  • Portland, OR
National Provider Identifier
1992249940
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP60705517 Issued in WA
Practice address
9135 SW Barnes Rd Ste 461
Portland, OR 97225-6643
Phone
(503) 216-1150
NPI assigned
Dec 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Nurse Practitioner 363LC0200X AP60705517 WA
Gerontology Nurse Practitioner 363LG0600X 201810082NP-PP OR
Acute Care Nurse Practitioner 363LA2100X AP60705517 WA Primary

Addresses

Primary practice location

9135 SW Barnes Rd Ste 461
Portland, OR 97225-6643

Mailing address

PO Box 3158
Portland, OR 97208-3158

Other practice location 1

200 NE Mother Joseph Pl Ste 330
Vancouver, WA 98664-3288
Phone (360) 514-2990

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jrendon1015655@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20170303000461 WA Practitioner - Nurse Practitioner 8325322746 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Duke University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PeacehealthGroup PAC ID 8820178288, 245 clinicians

Practice addresses (Care Compare)

200 NE Mother Joseph PL
Suite 330
Vancouver, WA 98664-3288
Phone (360) 514-2990

Hospital & facility affiliations

  • Peacehealth Southwest Medical Cente Hospital, Vancouver, WA, CCN 500050

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP60705517WAMDAcute Care Nurse Practitioner
201810082NP-PPORMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
RCCH Trios Health LLC CurrentSince Aug 1, 2018 Accepting new patients
Peacehealth CurrentSince Oct 7, 2023 Accepting new patients

Locations

900 S Auburn St
Kennewick, WA 99336
Phone (509) 586-5111

216 W 10th Ave
Ste 204
Kennewick, WA 99336
Phone (509) 221-5520

3810 Plaza Way
Kennewick, WA 99338
Phone (509) 221-7000

505 NE 87th Ave
Ste 301
Vancouver, WA 98664
Phone (360) 514-1854

200 NE Mother Joseph Pl
Ste 330
Vancouver, WA 98664
Phone (360) 514-2990

1115 SE 164th Ave
Dept 364
Vancouver, WA 98683
Phone (360) 735-8100

Interoperability endpoints

  • Direct secure messaging: jrendon624216@direct.peacehealth.org

Organizations & group practices 2

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1481241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1992249940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9135 SW BARNES RD STE 461",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256643",
            "telephone_number": "503-216-1150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 NE Mother Joseph Pl Ste 330",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986643288",
            "country_code": "US",
            "telephone_number": "360-514-2990",
            "fax_number": "360-514-3508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RENDON",
        "first_name": "JULIE",
        "name_prefix": "Ms.",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-09",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "WA",
            "license": "AP60705517",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OR",
            "license": "201810082NP-PP",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WA",
            "license": "AP60705517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jrendon1015655@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9135 SW Barnes Rd Ste 461",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972256643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.