Jandra Oliver, MSN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

10060084 Issued in OR

Practice address

51 SW Lee St
Newport, OR 97365-3823

Phone

(541) 265-4179

NPI assigned

Jan 23, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VT, OR2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northern Counties Health Care IncGroup PAC ID 2860300936, 48 clinicians

County of LincolnGroup PAC ID 3375439862, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

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 and National Provider Directory roles.

• Northern Counties Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • St Johnsbury, VT
  • NPI 1649236225
  Medicare reassignment Care Compare group NPD
• County of Lincoln

  • Federally Qualified Health Center (FQHC)
  • Newport, OR
  • NPI 1992755664
  Medicare reassignment Care Compare group
• Northern Counties Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Newport, VT
  • NPI 1003564931
  NPD

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

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786060800000",
    "number": "1033673181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 SE BAY BLVD # 434",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973654201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 SW LEE ST",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973653823",
            "telephone_number": "541-265-4179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "JANDRA",
        "credential": "MSN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-23",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VT",
            "license": "101.0136169",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95052543",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10060084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500877155",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Newport, OR
• Providers in Newport, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.