Individual provider Active NPI

Jill B Loy, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Eugene, OR
National Provider Identifier
1255641205
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
202007656NP-PP Issued in OR
Practice address
66 Club Rd Ste 160
Eugene, OR 97401-2439
Phone
(541) 345-1722
Fax
(541) 485-7049
NPI assigned
Oct 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 200141624RN OR
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 202007656NP-PP OR Primary

Addresses

Primary practice location

66 Club Rd Ste 160
Eugene, OR 97401-2439

Mailing address

PO Box 70779
Springfield, OR 97475-0137
Phone (541) 345-1722

Other identifiers 2

IdentifierTypeStateIssuer
14985999OtherCAQH ID
500785058MedicaidOR

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
I20201204000272 OR Practitioner - Nurse Practitioner 3779994298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amber Benson Pmhnp PCGroup PAC ID 3072786755, 24 clinicians

Practice addresses (Care Compare)

66 Club Rd
Suite 160
Eugene, OR 97401-2439
Phone (541) 345-1722

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200141624RNORMDRegistered Nurse
202007656NP-PPORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Amber Benson Pmhnp PC Psychiatric/Mental Health CurrentSince Oct 19, 2020 Accepting new patients

Locations

66 Club Rd
Ste 160
Eugene, OR 97401
Phone (541) 345-1722

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1286496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1255641205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70779",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974750137",
            "telephone_number": "541-345-1722",
            "fax_number": "541-485-7049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 CLUB RD STE 160",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012439",
            "telephone_number": "541-345-1722",
            "fax_number": "541-485-7049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOY",
        "first_name": "JILL",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-08",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "200141624RN",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "202007656NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH ID",
            "identifier": "14985999",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500785058",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.