Jennifer Catherine Marie Nelson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

201801111NP-PP Issued in OR

Practice address

151 SW Shevlin Hixon Dr Ste 201
Bend, OR 97702-3233

Phone

(541) 213-2265

Fax

(541) 508-5461

NPI assigned

Feb 12, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 1, 2026 through Oct 1, 2028

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.

• Paulina Peak Family Healthcare Inc

  • Family Nurse Practitioner
  • La Pine, OR
  • NPI 1184784332
  NPD (past)

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

{
    "created_epoch": "1518393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1174022586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 SW SHEVLIN HIXON DR STE 201",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023233",
            "telephone_number": "541-213-2265",
            "fax_number": "541-508-5461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 SW SHEVLIN HIXON DR STE 201",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023233",
            "telephone_number": "541-213-2265",
            "fax_number": "541-508-5461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JENNIFER",
        "middle_name": "CATHERINE MARIE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-12",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201801111NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda K Nelson, M.D.
• Carol-Ann Nelson, PT, DPT
• Grace Nelson
• Heidi Marie Nelson, L.M.T.
• James O Nelson, MD
• Jessica Anne Nelson
• Jihan Nelson
• Joe L Nelson
• Laura Nelson, OTR
• Linda Marianne Nelson, BS, CADC II

• Family Nurse Practitioner in Bend, OR
• Providers in Bend, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.