Sarah Kuppenbender Kong, FNP-C
Nurse Practitioner, Family in Portland, OR. Individual provider (NPI-1).
NPI number1013434646
StatusActive
Last updated in NPPESApr 25, 2019
Details
- NPI
- 1013434646
- Entity type
- Individual (NPI-1)
- Name
- Sarah Kuppenbender Kong
- Credential
- FNP-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 24, 2017
- Last updated
- Apr 25, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 201706888NP-PP | OR | Yes |
Practice location
4411 Sw Vermont StPortland, OR 97219-1020
Phone 503-494-9992
Mailing address
12960 Sw Douglas StPortland, OR 97225-4548
Phone 503-551-9099
Other practice locations
1620 E 12th St
The Dalles, OR 97058-3213
The Dalles, OR 97058-3213
Phone 541-296-9151 · Fax 541-296-9156
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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