Bethany Kristine Jensen, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

202010385NP-PP Issued in OR

Practice address

3180 Center St NE Ste 2100
Salem, OR 97301-4532

Phone

(503) 588-5351

NPI assigned

Nov 13, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Bethany K Fowler Other name

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

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.

• Precision Mental Performance LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Salem, OR
  • NPI 1780166116
  Medicare reassignment NPD
• Valuecore Mental Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Canby, OR
  • NPI 1093444622
  NPD (past)

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

{
    "created_epoch": "1605225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605225600000",
    "number": "1124620117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3455 SW US VETERANS HOSPITAL RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393076",
            "telephone_number": "503-983-6089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 CENTER ST NE STE 2100",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014532",
            "telephone_number": "503-588-5351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2421 Lancaster Dr NE",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973051220",
            "country_code": "US",
            "telephone_number": "503-588-5352",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "BETHANY",
        "middle_name": "KRISTINE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-13",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "202010385NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETHANY",
            "last_name": "FOWLER",
            "middle_name": "K",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jeffrey L. Turcot M.D., P.C.
• Christine Nicole Jeffries, MA, QMHA
• Janay R Jenniches, LMT
• Melissa Elaine Jenniches, CADC I, QMHA I, CRM
• Annette Marie Jensen, QMHA
• Cara Jensen, RDH
• Elizabeth A Jensen, MA
• Heather Mellen Jensen, O.D.
• Linda Louise Jensen, MD
• William Jensen

• Psychiatric/Mental Health Nurse Practitioner in Salem, OR
• Providers in Salem, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2020; 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.