Active NPI
Jennifer Marie Beal, P.T.A.
- Community Health Worker
- Bend, OR
National Provider Identifier
1265758064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- 7828
- Practice address
- 2366 NW Lakeside PL
Bend, OR 97701-3535 - Phone
- (541) 382-0479
- NPI assigned
- Apr 19, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 7828 | OR | Primary |
Addresses
Primary practice location
2366 NW Lakeside PL
Bend, OR 97701-3535
Mailing address
1943 NW 22ND St
Redmond, OR 97756-8449
Phone (541) 280-4050
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7828 | OR | MD | Community Health Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ohana Harmony House, LLC | Past | Accepting new patients | |
| Harmony House Nursing Home | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Skilled Nursing Facility
- Bend, OR
- NPI 1801970470
-
- Skilled Nursing Facility
- Bend, OR
- NPI 1790925428
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271635200000",
"number": "1265758064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1943 NW 22ND ST",
"city": "REDMOND",
"state": "OR",
"postal_code": "977568449",
"telephone_number": "541-280-4050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2366 NW LAKESIDE PL",
"city": "BEND",
"state": "OR",
"postal_code": "977013535",
"telephone_number": "541-382-0479"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAL",
"first_name": "JENNIFER",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "P.T.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-19",
"last_updated": "2010-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "OR",
"license": "7828",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.