Individual provider Active NPI

Jennifer Pauline Gardner, FNP

  • Gerontology Nurse Practitioner
  • Eugene, OR
National Provider Identifier
1235908567
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
10023094 Issued in OR
Practice address
217 Division Ave
Eugene, OR 97404-5429
Phone
(541) 780-6654
NPI assigned
Dec 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 202005793 OR
Family Nurse Practitioner 363LF0000X 10023094 OR
Gerontology Nurse Practitioner 363LG0600X 10023094 OR Primary

Addresses

Primary practice location

217 Division Ave
Eugene, OR 97404-5429

Mailing address

557 Honeysuckle LN
Eugene, OR 97401-5308
Phone (541) 954-1173

Other practice location 1

4010 Aerial Way
Eugene, OR 97402-9757
Phone (541) 242-8300

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
I20240531000258 OR Practitioner - Nurse Practitioner 9739521030 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1115 SE 164TH Ave
Dept 358
Vancouver, WA 98683-8004

217 Division Ave
Eugene, OR 97404-5423

5601 Captains LN
Wilmington, NC 28409-3619

PO Box
Suite 1602
Lake Oswego, OR 97035-0562

Hospital & facility affiliations

  • Sacred Heart Home Health Home health agency, Springfield, OR, CCN 387023
  • Sacred Heart Medical Center - Riverbend Hospital, Springfield, OR, CCN 380102

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
202005793ORMDRegistered Nurse
10023094ORMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Sports and Interventional Spine, LLC CurrentSince Apr 17, 2024 Accepting new patients
Pacific Sports and Interventional Spine, LLC-P CurrentSince Apr 17, 2024 Accepting new patients
Peacehealth Medical Group CurrentSince Jul 15, 2025 Accepting new patients
Peacehealth CurrentSince Aug 1, 2025 Accepting new patients
Oregon Pain & Spine Specialists PC CurrentSince May 1, 2025 Accepting new patients

Locations

1711 Willamette St
Ste 302
Eugene, OR 97401
Phone (541) 357-4536

360 S Garden Way
Ste 230
Eugene, OR 97401
Phone (541) 344-4168

4010 Aerial Way
Eugene, OR 97402
Phone (541) 242-8300

217 Division Ave
Eugene, OR 97404
Phone (541) 686-3791

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

Interoperability endpoints

  • Direct secure messaging: jgardner398794@direct.peacehealth.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/CECFDD

Organizations & group practices 5

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 3

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": "1703721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1235908567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "557 HONEYSUCKLE LN",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974015308",
            "telephone_number": "541-954-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 DIVISION AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974045429",
            "telephone_number": "541-780-6654"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4010 Aerial Way",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974029757",
            "country_code": "US",
            "telephone_number": "541-242-8300",
            "fax_number": "541-242-8335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "JENNIFER",
        "middle_name": "PAULINE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-28",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "202005793",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "10023094",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OR",
            "license": "10023094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.