Active NPI
Jennifer Lyn Bard, MD
- Family Medicine Physician
- Longview, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- WA MD00036509
- Practice address
- 1230 7TH Ave
Longview, WA 98632-3166 - Phone
- (360) 575-4801
- NPI assigned
- Sep 20, 2006
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | WA MD00036509 | WA | Primary |
Addresses
Primary practice location
1230 7TH Ave
Longview, WA 98632-3166
Mailing address
272 Pare Rd
Kelso, WA 98626-9639
Phone (360) 423-9263
Other names 1
- Jennifer Lyn Annett
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA, OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070908000060 | WA | Practitioner - Family Practice | 4981797859 | Reassigns benefits to 1 organization |
| I20090807000185 | OR | Practitioner - Family Practice | 4981797859 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Albany Medical College of Union University, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1230 7TH Ave
Longview, WA 98632-3166
Phone (800) 813-2000
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| WA MD00036509 | WA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Northwest | Family Medicine | Current | Accepting new patients |
| Kaiser Foundation Health Plan of the Northwest | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Northwest | Family Medicine | Current | Accepting new patients |
| Kaiser Foundation Health Plan of the Northwest | Family Medicine | Current | Accepting new patients |
Locations
10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946
7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051
13705 NE Airport Way
Portland, OR 97230
Phone (503) 258-6800
2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400
1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801
7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000
2211 E Mill Plain Blvd
Vancouver, WA 98661
Phone (360) 418-6001
Organizations & group practices 4
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.
-
- General Practice Physician
- Portland, OR
- NPI 1184786527
Family Medicine, OR, WA
-
- General Practice Physician
- Portland, OR
- NPI 1306192455
Family Medicine
-
- General Practice Physician
- Portland, OR
- NPI 1871848457
Family Medicine
-
- Clinic/Center
- Hillsboro, OR
- NPI 1942718622
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1346348596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "272 PARE RD",
"city": "KELSO",
"state": "WA",
"postal_code": "986269639",
"telephone_number": "360-423-9263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1230 7TH AVE",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "986323166",
"telephone_number": "360-575-4801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARD",
"first_name": "JENNIFER",
"middle_name": "LYN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "WA MD00036509",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "ANNETT",
"middle_name": "LYN",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Longview, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.