Individual provider Active NPI

Jenna Lynn Shenk, D.O.

  • Critical Care Medicine (Internal Medicine) Physician
  • Springfield, OR
National Provider Identifier
1174819502
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
DO188065 Issued in OR
Practice address
3377 Riverbend Dr
Springfield, OR 97477-8803
Phone
(541) 222-8400
Fax
(541) 222-8401
NPI assigned
Jun 23, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OT014451 PA
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X DO188065 OR
Internal Medicine Physician 207R00000X OT014451 PA
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X DO188065 OR
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X DO188065 OR Primary

Addresses

Primary practice location

3377 Riverbend Dr
Springfield, OR 97477-8803

Mailing address

3355 Riverbend Dr Ste 240
Springfield, OR 97477-8800

Other practice location 1

10800 Knights Rd
Philadelphia, PA 19114-4200
Phone (215) 612-4000

Other practice location 2

1515 Village Dr
Cottage Grove, OR 97424-9700
Phone (541) 767-5222

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190731002106 OR Practitioner - Emergency MedicinePractitioner - Critical Care (Intensivists) 3375839525 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sound Physicians Intensivists of Washington PLLCGroup PAC ID 5395018808, 81 clinicians

Practice addresses (Care Compare)

1460 G St
Springfield, OR 97477-4112
Phone (541) 726-4400

3333 Riverbend Dr
Springfield, OR 97477-8800
Phone (541) 222-7300

Hospital & facility affiliations

  • Sacred Heart Medical Center - Riverbend Hospital, Springfield, OR, CCN 380102
  • Peacehealth Cottage Grove Community Medical Center Hospital, Cottage Grove, OR, CCN 381301
  • Bay Area Hospital Hospital, Coos Bay, OR, CCN 380090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth Medical Group Cottage Grove Multi-Specialty Current Accepting new patients
Sound Physicians Intensivists of Washington PLLC Multi-Specialty CurrentSince Feb 15, 2023 Accepting new patients
Eugene Emergency Physicians PC Multi-Specialty CurrentSince Nov 1, 2019 Accepting new patients
Peacehealth Multi-Specialty CurrentSince Dec 17, 2019 Accepting new patients
Peacehealth Multi-Specialty CurrentSince Aug 14, 2022 Accepting new patients
Peacehealth Multi-Specialty Past Accepting new patients

Locations

1515 Village Dr
Cottage Grove, OR 97424
Phone (541) 767-5200

1255 Hilyard St
Eugene, OR 97401
Phone (503) 686-7300

2801 NW Mercy Dr
Ste 350
Roseburg, OR 97471
Phone (541) 222-2700

3355 Riverbend Dr
Ste 240
Springfield, OR 97477
Phone (541) 687-1712

3333 Riverbend Dr
Springfield, OR 97477
Phone (541) 222-3154

1460 G St
Springfield, OR 97477
Phone (541) 431-0665

Organizations & group practices 6

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1174819502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 RIVERBEND DR STE 240",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974778800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3377 RIVERBEND DR",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974778803",
            "telephone_number": "541-222-8400",
            "fax_number": "541-222-8401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10800 Knights Rd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191144200",
            "country_code": "US",
            "telephone_number": "215-612-4000",
            "fax_number": "215-612-4839",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1515 Village Dr",
            "address_purpose": "LOCATION",
            "city": "Cottage Grove",
            "state": "OR",
            "postal_code": "974249700",
            "country_code": "US",
            "telephone_number": "541-767-5222",
            "fax_number": "541-767-5230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHENK",
        "first_name": "JENNA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-23",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OT014451",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "DO188065",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OT014451",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "DO188065",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OR",
            "license": "DO188065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OR

Sources for this page

Verify at the official NPI Registry.