Individual provider Active NPI

Jennifer Elaine Mueller, M.D.

  • Family Medicine Physician
  • McMinnville, OR
National Provider Identifier
1093740268
Registry record updated Jul 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD171189 Issued in OR
Practice address
115 NE May LN
McMinnville, OR 97128-9272
Phone
(503) 472-1338
Fax
(503) 434-8597
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD171189 OR Primary

Addresses

Primary practice location

115 NE May LN
McMinnville, OR 97128-9272

Mailing address

PO Box 568
Cornelius, OR 97113-0568
Phone (503) 352-8642

Other identifiers 1

IdentifierTypeStateIssuer
MD171189OtherOROR MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150609002940 OR Practitioner - Family Practice 1850368168 Reassigns benefits to 2 organizations
I20231110000847 WA Practitioner - Family Practice 1850368168 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Human Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9800 SE Sunnyside Rd
Clackamas, OR 97015-9750
Phone (800) 813-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD171189ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest Family Medicine CurrentSince Sep 20, 2016 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Sep 20, 2016 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Family Medicine CurrentSince Sep 19, 2023 Accepting new patients
St. Luke's Hospital of Duluth Past Accepting new patients

Locations

9800 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2457

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Organizations & group practices 5

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1093740268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 568",
            "city": "CORNELIUS",
            "state": "OR",
            "postal_code": "971130568",
            "telephone_number": "503-352-8642",
            "fax_number": "503-352-8648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 NE MAY LN",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971289272",
            "telephone_number": "503-472-1338",
            "fax_number": "503-434-8597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUELLER",
        "first_name": "JENNIFER",
        "middle_name": "ELAINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD171189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OR MEDICAL LICENSE",
            "identifier": "MD171189",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McMinnville, OR

Sources for this page

Verify at the official NPI Registry.