Active NPI
Jolyn Ann Zeller, PMHNP
- Psychiatric/Mental Health Nurse Practitioner
- Keizer, OR
National Provider Identifier
1447241245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 200350049NP
- Practice address
- 3787 River Rd North
River Rd Plaza Suite a
Keizer, OR 97303 - Phone
- (503) 763-1778
- Fax
- (503) 980-7888
- NPI assigned
- Oct 31, 2005
- Last updated
- Oct 19, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 200350049NP | OR | Primary |
Addresses
Primary practice location
3787 River Rd North
River Rd Plaza Suite a
Keizer, OR 97303
Mailing address
PO Box 18180
Salem, OR 97305
Phone (503) 763-1778
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 240505 | Medicaid | OR |
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 |
|---|---|---|---|
| 200350049NP | OR | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Solarity Mental Health, PC | Psychiatric/Mental Health | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychiatric/Mental Health Nurse Practitioner
- Keizer, OR
- NPI 1578744355
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445212800000",
"number": "1447241245",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 18180",
"city": "SALEM",
"state": "OR",
"postal_code": "97305",
"telephone_number": "503-763-1778",
"fax_number": "503-980-7888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3787 RIVER RD NORTH",
"address_2": "RIVER RD PLAZA SUITE A",
"city": "KEIZER",
"state": "OR",
"postal_code": "97303",
"telephone_number": "503-763-1778",
"fax_number": "503-980-7888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZELLER",
"first_name": "JOLYN",
"middle_name": "ANN",
"credential": "PMHNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-10-31",
"last_updated": "2015-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "OR",
"license": "200350049NP",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "240505",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Keizer, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.