Individual provider Active NPI

Jenny V Tausch, APRN PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Coos Bay, OR
National Provider Identifier
1023649605
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
20200109NP-PP Issued in OR
Practice address
320 Central Ave Ste 212
Coos Bay, OR 97420-2241
Phone
(401) 217-9333
Fax
(541) 543-2470
NPI assigned
Jan 31, 2020
Last updated
Dec 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 20200109NP-PP OR Primary

Addresses

Primary practice location

320 Central Ave Ste 212
Coos Bay, OR 97420-2241

Mailing address

320 Central Ave Ste 212
Coos Bay, OR 97420-2241
Phone (401) 217-9333

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL EHR Other

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
I20200529001985 OR Practitioner - Nurse Practitioner 6608297619 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bay Area Hospital DistrictGroup PAC ID 2163331000, 117 clinicians

Practice addresses (Care Compare)

1775 Thompson Rd
Coos Bay, OR 97420-2125
Phone (541) 269-8280

320 Central Ave
Suite 212
Coos Bay, OR 97420-2241
Phone (401) 217-9333

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.45 of 100Reported as group
Quality
69.6
Promoting interoperability
100
Improvement activities
40
Cost
76.59

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20200109NP-PPORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Area Hospital District CurrentSince Apr 17, 2023 Accepting new patients
Bay Area Hospital District CurrentSince Apr 17, 2023 Accepting new patients
Monarch Mental Health LLC Psychiatric/Mental Health CurrentSince Feb 23, 2022 Accepting new patients
Second Wind Mental Health Clinic CurrentSince Mar 1, 2020 Accepting new patients

Locations

Dept LA 25339
Pasadena, CA 91185

1775 Thompson Rd
Coos Bay, OR 97420
Phone (541) 269-8090

2650 N 17th St
Coos Bay, OR 97420
Phone (541) 267-5411

320 Central Ave
Ste 212
Coos Bay, OR 97420
Phone (401) 217-9333

11 SW Brantley Dr
Winston, OR 97496
Phone (541) 679-0366

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1580428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1023649605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 CENTRAL AVE STE 212",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202241",
            "telephone_number": "401-217-9333",
            "fax_number": "541-543-2470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 CENTRAL AVE STE 212",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202241",
            "telephone_number": "401-217-9333",
            "fax_number": "541-543-2470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAUSCH",
        "first_name": "JENNY",
        "middle_name": "V",
        "credential": "APRN PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-31",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "20200109NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "EHR",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "EHR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "320 Central Ave Ste 212",
            "city": "Coos Bay",
            "state": "OR",
            "country_code": "US",
            "postal_code": "974202241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coos Bay, OR

Sources for this page

Verify at the official NPI Registry.