Active NPI
Jennifer A Hearn, PSS
- Peer Specialist
- Salem, OR
National Provider Identifier
1124693379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- THW000004312
- Practice address
- 2995 Ryan Dr SE Ste 200
Salem, OR 97301-5157 - Phone
- (503) 587-5151
- Fax
- (503) 581-8192
- NPI assigned
- May 20, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | THW000004312 | OR | Primary |
Addresses
Primary practice location
2995 Ryan Dr SE Ste 200
Salem, OR 97301-5157
Mailing address
2995 Ryan Dr SE Ste 200
Salem, OR 97301-5157
Phone (503) 587-5151
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| THW000004312 | OR | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648684800000",
"number": "1124693379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2995 RYAN DR SE STE 200",
"city": "SALEM",
"state": "OR",
"postal_code": "973015157",
"telephone_number": "503-587-5151",
"fax_number": "503-581-8192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2995 RYAN DR SE STE 200",
"city": "SALEM",
"state": "OR",
"postal_code": "973015157",
"telephone_number": "503-587-5151",
"fax_number": "503-581-8192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEARN",
"first_name": "JENNIFER",
"middle_name": "A",
"credential": "PSS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-20",
"last_updated": "2022-03-31",
"certification_date": "2021-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "OR",
"license": "THW000004312",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.