Individual provider Active NPI

Jaclyn Smith, NP

  • Nurse Practitioner
  • Bend, OR
National Provider Identifier
1013419530
Registry record updated Apr 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
201801521NP-PP Issued in OR
Practice address
2600 NE Neff Rd
Bend, OR 97701-6337
Phone
(541) 706-7735
Fax
(541) 706-4806
NPI assigned
Feb 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 201801521NP-PP OR Primary

Addresses

Primary practice location

2600 NE Neff Rd
Bend, OR 97701-6337

Mailing address

21215 Dove LN
Bend, OR 97702-9526
Phone (541) 233-3872

Other practice location 1

21215 Dove Ln
Bend, OR 97702-9526
Phone (541) 233-3872

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jsmith98626@secure.stcharleshealthcare.org

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190327002837 OR Practitioner - Nurse Practitioner 3678813748 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Charles Health System IncGroup PAC ID 8729111513, 379 clinicians

Practice addresses (Care Compare)

1253 NW Canal Blvd
Adv Illness Manag
Redmond, OR 97756-1334
Phone (541) 706-5880

211 NW Larch Ave
Family Care
Redmond, OR 97756-1357
Phone (541) 548-2164

2500 NE Neff Rd
Bend, OR 97701-6015

2600 NE Neff Rd
SCMG Imaging
Bend, OR 97701-6337
Phone (541) 706-4905

51781 Huntington Rd
La Pine, OR 97739-1118
Phone (541) 666-7920

655 NW Jackpine Ave
Sleep Cent
Redmond, OR 97756-1334
Phone (541) 526-6661

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201801521NP-PPORMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bend Memorial Clinic PC Nurse Practitioner Current Accepting new patients
St. Charles Health System, Inc. CurrentSince Mar 30, 2020 Accepting new patients
Daiya Healthcare PLLC CurrentSince Jul 11, 2025 Accepting new patients
Bend Memorial Clinic PC CurrentSince Feb 18, 2019 Accepting new patients
St. Charles Health System, Inc. CurrentSince Mar 30, 2020 Accepting new patients
St. Charles Health System, Inc. Current Accepting new patients
St. Charles Health System, Inc. CurrentSince Oct 1, 2020 Accepting new patients

Locations

29358 Network Pl
Chicago, IL 60673

2600 NE Neff Rd
Bend, OR 97701
Phone (541) 706-3700

1501 NE Medical Center Dr
Bend, OR 97701
Phone (541) 317-4354

2275 NE Doctors Dr
Ste 6
Bend, OR 97701
Phone (541) 389-3166

2500 NE Neff Rd
Bend, OR 97701
Phone (541) 388-4333

10435 SE Cora St
Portland, OR 97266
Phone (503) 760-1737

211 NW Larch Ave
Redmond, OR 97756
Phone (541) 548-2164

1253 NW Canal Blvd
Redmond, OR 97756
Phone (541) 548-8131

75 Shore Dr
Saint Helens, OR 97051
Phone (503) 397-2713

Interoperability endpoints

  • Direct secure messaging: jsmith98626@secure.stcharleshealthcare.org

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 3

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": "1519776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776297600000",
    "number": "1013419530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21215 DOVE LN",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977029526",
            "telephone_number": "541-233-3872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 NE NEFF RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016337",
            "telephone_number": "541-706-7735",
            "fax_number": "541-706-4806"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21215 Dove Ln",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977029526",
            "country_code": "US",
            "telephone_number": "541-233-3872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACLYN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-28",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "201801521NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsmith98626@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "2600 NE Neff Rd",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977016337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.