Active NPI
Jeanette Walker, MD
- Family Medicine Physician
- Salem, OR
National Provider Identifier
1033347430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD161788
- Practice address
- 5560 Witzel Rd SE
Salem, OR 97317-9142 - Phone
- (503) 581-8251
- Fax
- (866) 372-4073
- NPI assigned
- Jun 24, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD161788 | OR | Primary |
Addresses
Primary practice location
5560 Witzel Rd SE
Salem, OR 97317-9142
Mailing address
5560 Witzel Rd SE
Salem, OR 97317-9142
Phone (503) 581-8251
Other practice location 1
777 N Raymond St
Boise, ID 83704-9251
Phone (208) 367-6030
Other names 1
- Jeanette Monson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210406001576 | MT | Order and Referring Only - Family Practice | 8628227253 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Groundswell Integrative Healthcare Inc. | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Salem, OR
- NPI 1457790826
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525910400000",
"number": "1033347430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5560 WITZEL RD SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973179142",
"telephone_number": "503-581-8251",
"fax_number": "866-372-4073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5560 WITZEL RD SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973179142",
"telephone_number": "503-581-8251",
"fax_number": "866-372-4073"
}
],
"practiceLocations": [
{
"address_1": "777 N Raymond St",
"address_purpose": "LOCATION",
"city": "Boise",
"state": "ID",
"postal_code": "837049251",
"country_code": "US",
"telephone_number": "208-367-6030",
"fax_number": "208-322-7018",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALKER",
"first_name": "JEANETTE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-24",
"last_updated": "2018-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD161788",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JEANETTE",
"last_name": "MONSON",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.