Active NPI
Bridget Jenkins
- Peer Specialist
- Eugene, OR
National Provider Identifier
1104284900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 1200 Hilyard St Ste 570
Eugene, OR 97401-8168 - Phone
- (458) 205-7070
- Fax
- (458) 205-7089
- NPI assigned
- Feb 8, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 16-05-21 | OR | |
| Mental Health Counselor | 101YM0800X | |||
| Peer Specialist | 175T00000X | OR | Primary |
Addresses
Primary practice location
1200 Hilyard St Ste 570
Eugene, OR 97401-8168
Mailing address
687 Cheshire Ave
Eugene, OR 97402-5060
Phone (541) 684-4168
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500719317 | Medicaid | OR |
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1454889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517184000000",
"number": "1104284900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "687 CHESHIRE AVE",
"city": "EUGENE",
"state": "OR",
"postal_code": "974025060",
"telephone_number": "541-684-4168",
"fax_number": "541-684-4156"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 HILYARD ST STE 570",
"city": "EUGENE",
"state": "OR",
"postal_code": "974018168",
"telephone_number": "458-205-7070",
"fax_number": "458-205-7089"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS",
"first_name": "BRIDGET",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-02-08",
"last_updated": "2018-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OR",
"license": "16-05-21",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "OR",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500719317",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.