NPIMap

Organization Active NPI

Kristi Jett, MD

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Bend, OR
National Provider Identifier
1417049685
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X
License
MD14733 Issued in OR
Legal business name
KRISTI JETT, MD
Practice address
1102 NE 4TH St
Bend, OR 97701-4533
Phone
(541) 389-0450
Fax
(541) 389-9567
NPI assigned
Sep 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kristi J Jett, M.D.NPI 1073568762
Title
Owner/Physician
Phone
(541) 389-0450

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Neuromusculoskeletal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 204C00000X MD14733 OR Primary

Addresses

Primary practice location

1102 NE 4TH St
Bend, OR 97701-4533

Mailing address

1102 NE 4TH St
Bend, OR 97701-4533
Phone (541) 389-0450

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417049685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 NE 4TH ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014533",
            "telephone_number": "541-389-0450",
            "fax_number": "541-389-9567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 NE 4TH ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014533",
            "telephone_number": "541-389-0450",
            "fax_number": "541-389-9567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTI JETT, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JETT",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "541-389-0450",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "OR",
            "license": "MD14733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.