Jennifer S. Griswold, N.P.

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

202111832NP-PP Issued in OR

Practice address

1018 SW Emkay Dr
Bend, OR 97702-1010

Phone

(541) 716-0113

NPI assigned

Aug 17, 2006

Last updated

Jan 24, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bend Memorial Clinic PC

  dba Summit Health

  • Family Medicine Physician
  • Bend, OR
  • NPI 1699827477

  Nurse Practitioner

  Medicare reassignment NPD
• Healthy Minds Central Oregon

  • Psychiatry Physician
  • Bend, OR
  • NPI 1104531359
  NPD Authorized official
• Bend Memorial Clinic PC

  dba Bend Memorial Clinic PC dba Summit Health

  • Clinical Medical Laboratory
  • Bend, OR
  • NPI 1972144913
  NPD

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1245343870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 NE 3RD ST STE 3-301",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014700",
            "telephone_number": "541-716-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 SW EMKAY DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021010",
            "telephone_number": "541-716-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISWOLD",
        "first_name": "JENNIFER",
        "middle_name": "S.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP10774",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "200950013NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "202111832NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500604912",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "NP10774",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olen Grimes
• Sarah Marie Grimes
• Carla Jean Grinuck-Wood, NP-C
• Anne Grinyer
• Laurie Elizabeth Grisez, N.D.
• Madeline Groen
• Sierra Groenewold, LPC
• Misty Michelle Groom
• Jeannie Marie Gross
• Samuel Ross Gross

• Psychiatric/Mental Health Nurse Practitioner in Bend, OR
• Providers in Bend, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.