Jenna Maren Vernon, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

6904 Issued in OR

Practice address

1000 N Providence Dr Ste 120
Newberg, OR 97132-7582

Phone

(503) 537-5900

NPI assigned

Sep 6, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Providence Health & Services Oregon

  • General Practice Physician
  • Lake Oswego, OR
  • NPI 1023488343

  OR

  Medicare reassignment NPD
• Providence Health & Services - Oregon

  • Internal Medicine Physician
  • Newberg, OR
  • NPI 1023335403
  NPD
• Providence Health & Services - Oregon

  • Clinical Pathology Physician
  • Newberg, OR
  • NPI 1174074868
  NPD (past)

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

{
    "created_epoch": "1346889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1427307396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N PROVIDENCE DR STE 120",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971327582",
            "telephone_number": "503-537-5900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16770 SW Edy Rd Ste 310",
            "address_purpose": "LOCATION",
            "city": "Sherwood",
            "state": "OR",
            "postal_code": "97140",
            "country_code": "US",
            "telephone_number": "503-216-9731",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VERNON",
        "first_name": "JENNA",
        "middle_name": "MAREN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-06",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "6904",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "OR",
            "license": "6904",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Ann Upmeyer, LMT
• Valerie Fitzgerald
• Jennipher K. Vallery, PA-C
• Paige Vazquez, PHD
• Marilyn Vega, LPN
• VG Newberg Pharmacy
• David Villegas
• Virginia Garcia Memorial Health Center
• Virginia Garcia Memorial Health Center
• Vitality Massage & Bodywork

• All providers in Newberg, OR
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.