Active NPI
Jamie Bovik
- Community Health Worker
- La Pine, OR
National Provider Identifier
1407450232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- THW000004135
- Practice address
- 51600 Huntington Rd
La Pine, OR 97739-8887 - Phone
- (541) 536-3435
- NPI assigned
- Nov 23, 2020
- 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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | THW000004135 | OR | Primary |
Addresses
Primary practice location
51600 Huntington Rd
La Pine, OR 97739-8887
Mailing address
PO Box 3300
La Pine, OR 97739-3300
Phone (541) 536-3435
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
| License | State | Type | Specialty |
|---|---|---|---|
| THW000004135 | OR | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606089600000",
"number": "1407450232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3300",
"city": "LA PINE",
"state": "OR",
"postal_code": "977393300",
"telephone_number": "541-536-3435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51600 HUNTINGTON RD",
"city": "LA PINE",
"state": "OR",
"postal_code": "977398887",
"telephone_number": "541-536-3435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOVIK",
"first_name": "JAMIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-23",
"last_updated": "2020-11-23",
"certification_date": "2020-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "OR",
"license": "THW000004135",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Pine, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.