Individual provider Active NPI

Jillian Elaine Pennington, FNP

  • Family Nurse Practitioner
  • Newberg, OR
National Provider Identifier
1225910649
Registry record updated Sep 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10047716 Issued in OR
Practice address
1003 N Providence Dr Ste 210
Newberg, OR 97132-7523
Phone
(503) 537-5620
NPI assigned
Jul 24, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 10047716 OR
Family Nurse Practitioner 363LF0000X 10047716 OR Primary

Addresses

Primary practice location

1003 N Providence Dr Ste 210
Newberg, OR 97132-7523

Mailing address

1003 N Providence Dr Ste 210
Newberg, OR 97132-7523
Phone (503) 537-5620

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250830000114 OR Practitioner - Nurse Practitioner 3870094857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
George Washington University School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1003 N Providence Dr
Suite 210
Newberg, OR 97132-7523
Phone (503) 537-5620

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10047716ORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon CurrentSince Sep 22, 2025 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Sep 22, 2025 Accepting new patients

Locations

1003 N Providence Dr
Ste 210
Newberg, OR 97132
Phone (503) 537-5620

1003 N Providence Dr
Ste 325
Newberg, OR 97132
Phone (503) 216-1661

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

Interoperability endpoints

  • Direct secure messaging: jpennington2667304@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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1753315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758412800000",
    "number": "1225910649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 N PROVIDENCE DR STE 210",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971327523",
            "telephone_number": "503-537-5620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 N PROVIDENCE DR STE 210",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971327523",
            "telephone_number": "503-537-5620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "JILLIAN",
        "middle_name": "ELAINE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-24",
        "last_updated": "2025-09-21",
        "certification_date": "2025-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "10047716",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "10047716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newberg, OR

Sources for this page

Verify at the official NPI Registry.