Active NPI
Luke William Jennings, RN
- Registered Nurse
- Portland, OR
National Provider Identifier
1437556792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 201406223RN
- Practice address
- 1132 SW 13TH Ave
Portland, OR 97205-1703 - Phone
- (503) 223-3860
- Fax
- (503) 223-6837
- NPI assigned
- Dec 1, 2014
- Last updated
- Dec 1, 2014
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 201406223RN | OR | Primary |
Addresses
Primary practice location
1132 SW 13TH Ave
Portland, OR 97205-1703
Mailing address
1223 NE Schuyler St
Apt 1
Portland, OR 97212-4330
Phone (617) 938-8536
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201406223RN | OR | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417392000000",
"number": "1437556792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1223 NE SCHUYLER ST",
"address_2": "APT 1",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972124330",
"telephone_number": "617-938-8536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1132 SW 13TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972051703",
"telephone_number": "503-223-3860",
"fax_number": "503-223-6837"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENNINGS",
"first_name": "LUKE",
"middle_name": "WILLIAM",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-12-01",
"last_updated": "2014-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OR",
"license": "201406223RN",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.