Jennifer Hanlon-Wilde, F.N.P.

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

098006694RN FNP-PP Issued in OR

Practice address

1810 E 19TH St
Suite 209
The Dalles, OR 97058-3388

Phone

(541) 296-5657

NPI assigned

Nov 10, 2005

Last updated

Feb 16, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mrs. Jennifer Hanlon Former name

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

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.

• Mid-Columbia Medical Center

  dba Adventist Health Columbia Gorge

  • General Practice Physician
  • The Dalles, OR
  • NPI 1053409599
  Medicare reassignment NPD
• Mid-Columbia Medical Center

  dba Adventist Health Columbia Gorge

  • Rural Health Clinic/Center
  • The Dalles, OR
  • NPI 1407887052

  Family

  NPD
• North Central Public Health District

  • Public Health or Welfare Agency
  • The Dalles, OR
  • NPI 1548376445
  NPD (past)

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518739200000",
    "number": "1033190574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1520",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970588003",
            "telephone_number": "541-296-5657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 E 19TH ST",
            "address_2": "SUITE 209",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583388",
            "telephone_number": "541-296-5657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANLON-WILDE",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-10",
        "last_updated": "2018-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "098006694NP",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OR",
            "license": "098006694RN FNP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "092586",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "HANLON",
            "prefix": "MRS.",
            "credential": "F.N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Patrick Grimsley, M.D.
• Hannah Michele Grooms, BA
• Michele Gullon, CADC II
• William Lee Guth, DDS
• William Claude Hamilton, M.D.
• Keeta Hardy
• Carson N Harper, MD
• Vern Harpole, M.D.
• Harris Physical Therapy - Sport & Spine Specialists, Inc
• Alyssa M Harris

• Women's Health Nurse Practitioner in The Dalles, OR
• Providers in The Dalles, OR by specialty
• Women's Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2018; 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.