Jeremy Rowe Kenison, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO214918 Issued in OR

Practice address

630 N Arrowleaf TRL
Sisters, OR 97759-2610

Phone

(541) 549-1318

Fax

(541) 588-6002

NPI assigned

Apr 8, 2013

Last updated

Oct 2, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Rocky Vista University College of Osteopathic Med, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St Charles Health System IncGroup PAC ID 8729111513, 379 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St. Charles Home Health Services Home health agency, Bend, OR, CCN 387026
• St Charles Medical Center - Bend Hospital, Bend, OR, CCN 380047

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St. Charles Health System, Inc.

  dba St. Charles Medical Group

  • Family Medicine Physician
  • Bend, OR
  • NPI 1023331303
  Medicare reassignment Care Compare group NPD
• St. Charles Health System, Inc.

  dba The Center at St. Charles Medical Equipment

  • Specialist
  • Bend, OR
  • NPI 1700697935
  NPD
• St. Charles Health System, Inc.

  dba St. Charles Medical Supply - Redmond

  • Oxygen Equipment & Supplies (DME)
  • Redmond, OR
  • NPI 1427140870
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cascade Healthcare Community Inc

  dba NW High Desert Sleep Center Bend

  • Sleep Disorder Diagnostic Clinic/Center
  • Bend, OR
  • NPI 1164675963

  Hospital

  Care Compare affiliation
• St. Charles Health System, Inc.

  dba St. Charles Home Health Services

  • Home Health Agency
  • Bend, OR
  • NPI 1144215542
  Care Compare affiliation
• St. Charles Health System, Inc.

  dba St. Charles Home Health

  • Home Health Agency
  • Madras, OR
  • NPI 1225226004
  Care Compare affiliation
• St. Charles Health System, Inc.

  dba St. Charles Bend

  • General Acute Care Hospital
  • Bend, OR
  • NPI 1982621447
  Care Compare affiliation

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

{
    "created_epoch": "1365379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1386087534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6095",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977086095",
            "telephone_number": "541-706-5922",
            "fax_number": "541-706-6869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 N ARROWLEAF TRL",
            "city": "SISTERS",
            "state": "OR",
            "postal_code": "977592610",
            "telephone_number": "541-549-1318",
            "fax_number": "541-588-6002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Boone Rd",
            "address_purpose": "LOCATION",
            "city": "Bremerton",
            "state": "WA",
            "postal_code": "983121894",
            "country_code": "US",
            "telephone_number": "360-475-4216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENISON",
        "first_name": "JEREMY",
        "middle_name": "ROWE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-08",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP 60502641",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO214918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkenison182555@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "630 N Arrowleaf Trl",
            "city": "Sisters",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977592610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Intawell Behavioral Health LLC
• Sara Johnson, CES
• Cassandra Jonestrask
• K. Zachary Sunitsch DMD LLC
• Patricia Joan Kauffman, M.D.
• Avery Ketchum
• Martha Woolsey King
• Ida Kolodziejczyk
• Timothy Korm, PMHNP-BC
• Kristi Lyn Rhodes

• Family Medicine Physician in Sisters, OR
• Providers in Sisters, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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.

Verify at the official NPI Registry.