Jerry L Foster, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R41699 Issued in NM

Practice address

1270 Kotnum Road
Warm Spring, OR 97761-1209

Phone

(541) 553-1196

NPI assigned

Jul 2, 2008

Last updated

Jun 8, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

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.

• US Health Dept of Health & Human Services

  • Rural Health Clinic/Center
  • Poplar, MT
  • NPI 1972694602

  TX

  Medicare reassignment NPD
• U S Health Dept of Health & Human Services

  dba Lodge Grass Clinic

  • Critical Access Hospital
  • Lodge Grass, MT
  • NPI 1750410395
  NPD
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433721600000",
    "number": "1053574772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1209",
            "city": "WARM SPRING",
            "state": "OR",
            "postal_code": "977611209",
            "telephone_number": "541-553-1196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 KOTNUM ROAD",
            "city": "WARM SPRING",
            "state": "OR",
            "postal_code": "977611209",
            "telephone_number": "541-553-1196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSTER",
        "first_name": "JERRY",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-02",
        "last_updated": "2015-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "R41699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273855",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; 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.