Individual provider Active NPI

Jean Ann Farmer, R.D.

  • Registered Dietitian
  • Pendleton, OR
National Provider Identifier
1073672002
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
354486 Issued in OR
Practice address
73265 Confederated Way
Pendleton, OR 97801
Phone
(541) 966-9830
Fax
(541) 278-7572
NPI assigned
Dec 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 354486 OR Primary

Addresses

Primary practice location

73265 Confederated Way
Pendleton, OR 97801

Mailing address

3211 SW Jay Ave
Pendleton, OR 97801-3634
Phone (541) 966-8980

Other identifiers 1

IdentifierTypeStateIssuer
171037MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
354486ORMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Assured Imaging Womens Wellness of Washington, LLC 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.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1073672002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3211 SW JAY AVE",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978013634",
            "telephone_number": "541-966-8980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73265 CONFEDERATED WAY",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "97801",
            "telephone_number": "541-966-9830",
            "fax_number": "541-278-7572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARMER",
        "first_name": "JEAN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "354486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171037",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pendleton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.