Individual provider Active NPI

Jessica Mayer, N.P.

  • Acute Care Nurse Practitioner
  • Portland, OR
National Provider Identifier
1386042315
Registry record updated Dec 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
201394462NP-PP Issued in OR
Practice address
122 SE 80TH Ave
Portland, OR 97215-1522
Phone
(520) 603-9573
NPI assigned
Dec 8, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 201394462NP-PP OR Primary

Addresses

Primary practice location

122 SE 80TH Ave
Portland, OR 97215-1522

Mailing address

122 SE 80TH Ave
Portland, OR 97215-1522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201394462NP-PPORMDAcute Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1417996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417996800000",
    "number": "1386042315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 SE 80TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 SE 80TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151522",
            "telephone_number": "520-603-9573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYER",
        "first_name": "JESSICA",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-08",
        "last_updated": "2014-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OR",
            "license": "201394462NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.