Jessica Ann Shrock, FNP--C
Individual provider Active NPI Family Nurse Practitioner · Bandon, OR
NPI 1184075715 · NPPES record last updated May 9, 2025
Key facts
- NPI
- 1184075715
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 10035565 (OR)
- Practice address
- 110 10TH St SE
Bandon, OR 97411-9157 - Phone
- (541) 347-5191
- Fax
- (541) 266-4578
- NPI assigned
- Jun 24, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- North Bend Medical Center Inc
Practice addresses (Care Compare)
110 E 10TH St
Bandon, OR 97411-9157
Phone (541) 396-3111
1900 Woodland Dr
Coos Bay, OR 97420-2045
Phone (541) 267-5151
Hospital & facility affiliations
- Oregon Coast Home Health
- South Coast Hospice
- Bay Area Hospital
- Southern Coos Hospital & Health Center
- Curry General Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.64 of 100
- Quality
- 74.2
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 66.56
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TN, OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161129000415 | TN | Practitioner - Nurse Practitioner | 0345520847 | Reassigns benefits to 1 organization |
| I20250113002274 | OR | Practitioner - Nurse Practitioner | 0345520847 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21334 | TN | MD | Rheumatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Bend Medical Center Inc | Current |
Accepting new patients | |
| Healogics Specialty Physicians of Tennessee, PLLC | Current |
Accepting new patients | |
| North Bend Medical Center Inc | Current |
Accepting new patients | |
| Wild Rivers Emergency Physicians LLC | Past | Accepting new patients |
Locations
110 10th St SE
Bandon, OR 97411
Phone (541) 347-1515
1900 Woodland Dr
Coos Bay, OR 97420
Phone (541) 267-5151
1801 N Jackson St
Tullahoma, TN 37388
Phone (931) 393-3000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 21334 | TN | |
| Family Nurse Practitioner | 363LF0000X | 10035565 | OR | Yes |
Addresses
Primary practice location
110 10TH St SE
Bandon, OR 97411-9157
Mailing address
1900 Woodland Dr
Coos Bay, OR 97420-2099
Phone (541) 267-5151
Other providers in Bandon, OR
- Merri Lynne Seegrist
- Mariarose M Shanahe
- Sharon C Strong DMD PC
- Ariel Jui-Yu Shih
- Shindler'S Drugstore Inc.
- Zakary G Shrock
- Paul Edward Smith
- Venus Crystal Smith
- Southern Coos Health District
- Southern Coos Health District
All providers in Bandon, OR · Family Nurse Practitioner in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 9, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.