Active NPI
Jennifer Marie Grant, PA
- Physician Assistant
- Oregon City, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA212952
- Practice address
- 1420 John Adams St
Oregon City, OR 97045-1609 - Phone
- (503) 656-1484
- Fax
- (503) 650-1976
- NPI assigned
- May 13, 2008
- Last updated
- Aug 5, 2025
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 005270 | GA | |
| Physician Assistant | 363A00000X | PA212952 | OR | Primary |
Addresses
Primary practice location
1420 John Adams St
Oregon City, OR 97045-1609
Mailing address
PO Box 1517
Pendleton, OR 97801-0410
Phone (877) 708-1119
Other practice location 1
140 N Crest Blvd
Macon, GA 31210-1845
Phone (478) 757-8335
Other names 1
- Mrs. Jennifer Marie Mullis Grant
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1420 John Adams St
Oregon City, OR 97045-1609
Phone (503) 656-1484
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005270 | GA | MD | Physician Assistant |
| PA212952 | OR | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Praxis Health, PC | Current | Accepting new patients | |
| Praxis Health, PC | Current | Accepting new patients | |
| Collier B. Gladin, Jr., M.D., LLC | Past | Accepting new patients |
Locations
4510 SW Hall Blvd
Beaverton, OR 97005
Phone (503) 644-1171
1420 John Adams St
Oregon City, OR 97045
Phone (503) 655-7235
Interoperability endpoints
- jgrant2620308@oc.providencedirect.org
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- Bend, OR
- NPI 1821068164
-
dba Collier B Gladin Jr MD
- Family Medicine Physician
- Macon, GA
- NPI 1780992198
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Providence Medical Group
- Clinic/Center
- Portland, OR
- NPI 1326272741
Hospital
-
dba Providence Willamette Falls Medical Center
- General Acute Care Hospital
- Oregon City, OR
- NPI 1912282369
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754352000000",
"number": "1144497736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1517",
"city": "PENDLETON",
"state": "OR",
"postal_code": "978010410",
"telephone_number": "877-708-1119",
"fax_number": "541-278-8349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1420 JOHN ADAMS ST",
"city": "OREGON CITY",
"state": "OR",
"postal_code": "970451609",
"telephone_number": "503-656-1484",
"fax_number": "503-650-1976"
}
],
"practiceLocations": [
{
"address_1": "140 N Crest Blvd",
"address_purpose": "LOCATION",
"city": "Macon",
"state": "GA",
"postal_code": "312101845",
"country_code": "US",
"telephone_number": "478-757-8335",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GRANT",
"first_name": "JENNIFER",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-13",
"last_updated": "2025-08-05",
"certification_date": "2025-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": "005270",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OR",
"license": "PA212952",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "MULLIS GRANT",
"middle_name": "MARIE",
"prefix": "MRS.",
"credential": "PA",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Oregon City, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.