Active NPI
Deborah J Vencill, NP
- Family Nurse Practitioner
- Baker City, OR
National Provider Identifier
1366430670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 079042283N1
- Practice address
- 3950 17TH St
Suite a
Baker City, OR 97814-1300 - Phone
- (541) 523-1001
- NPI assigned
- Oct 11, 2005
- 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 Nurse Practitioner | 363LF0000X | 079042283N1 | OR | Primary |
Addresses
Primary practice location
3950 17TH St
Suite a
Baker City, OR 97814-1300
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-2222
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 079042283N1 | OR | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michael H. McQueen M.D P.C | Past | Accepting new patients | |
| St. Elizabeth Health Services, Inc. | Past | Accepting new patients | |
| Saint Alphonsus Medical Center Baker City, Inc | Past | Accepting new patients | |
| North Powder School District 8J | Past | Accepting new patients |
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.
-
- Family Medicine Physician
- La Grande, OR
- NPI 1487603098
-
- Primary Care Clinic/Center
- North Powder, OR
- NPI 1609195700
-
- Family Medicine Physician
- Baker City, OR
- NPI 1881726206
-
- Durable Medical Equipment & Medical Supplies
- Baker City, OR
- NPI 1417089830
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347926400000",
"number": "1366430670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 E BANNOCK ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126241",
"telephone_number": "208-381-2222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3950 17TH ST",
"address_2": "SUITE A",
"city": "BAKER CITY",
"state": "OR",
"postal_code": "978141300",
"telephone_number": "541-523-1001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VENCILL",
"first_name": "DEBORAH",
"middle_name": "J",
"name_prefix": "Mrs.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-11",
"last_updated": "2012-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OR",
"license": "079042283N1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Baker City, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.