Individual provider Active NPI

Jennifer Redman, LPN

  • Licensed Practical Nurse
  • Portland, OR
National Provider Identifier
1346953239
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
201507075LPN Issued in OR
Practice address
745 NE 122ND Ave
Portland, OR 97230-2001
Phone
(503) 252-0241
Fax
(503) 253-1740
NPI assigned
Jan 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 201507075LPN OR Primary

Addresses

Primary practice location

745 NE 122ND Ave
Portland, OR 97230-2001

Mailing address

745 NE 122ND Ave
Portland, OR 97230-2001
Phone (503) 252-0241

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jennifer.redman@prestigecare.com

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

LicenseStateTypeSpecialty
201507075LPNORMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1672876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1346953239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 NE 122ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972302001",
            "telephone_number": "503-252-0241",
            "fax_number": "503-253-1740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 NE 122ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972302001",
            "telephone_number": "503-252-0241",
            "fax_number": "503-253-1740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDMAN",
        "first_name": "JENNIFER",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-05",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OR",
            "license": "201507075LPN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jennifer.redman@prestigecare.com",
            "affiliation": "N",
            "address_1": "745 NE 122nd Ave",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972302001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.