Justin P Dennery, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

202101566 Issued in OR

Practice address

676 NE Maple Ave
Redmond, OR 97756-8527

Phone

(602) 570-1237

NPI assigned

Aug 19, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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 and National Provider Directory roles.

• Icco, LLC

  • Urgent Care Clinic/Center
  • Eugene, OR
  • NPI 1407004757

  Single Specialty

  Medicare reassignment NPD
• Icco LLC

  • Rural Health Clinic/Center
  • Florence, OR
  • NPI 1740896547
  NPD
• Icco, LLC

  • Rural Health Clinic/Center
  • Junction City, OR
  • NPI 1649886441
  NPD
• Community Bridges, Inc.

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1649426909
  NPD (past)
• Community Bridges, Inc.

  • Nursing Care Agency
  • Phoenix, AZ
  • NPI 1891288049
  NPD (past)

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

{
    "created_epoch": "1471564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1073068078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1710",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977560516",
            "telephone_number": "541-504-9577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 NE MAPLE AVE",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977568527",
            "telephone_number": "602-570-1237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNERY",
        "first_name": "JUSTIN",
        "middle_name": "P",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-19",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP8638",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "202101566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deep Water Counseling
• Lauren Del Mar, SLP-CCC
• Rachel Elizabeth Delance
• Julia Delbeccaro
• Christina Dellera-Storo
• Deschutes Eye Clinic Inc
• Deschutes Eye Clinic PC
• Deschutes Laser Therapy. LLC
• Desert Bone & Joint Specialists LLP
• Desert Peaks Health Care, LLC

• Family Nurse Practitioner in Redmond, OR
• Providers in Redmond, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; 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.