Active NPI
Jonathan Ryan Fordyce, FNP-C
- Family Nurse Practitioner
- Portland, OR
National Provider Identifier
1447736608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP137863
- Practice address
- 417 SW 117TH Ave
Portland, OR 97225-5924 - Phone
- (503) 216-8980
- NPI assigned
- Jul 11, 2018
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP137863 | TX | Primary |
Addresses
Primary practice location
417 SW 117TH Ave
Portland, OR 97225-5924
Mailing address
PO Box 3158
Portland, OR 97208-3158
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500760115 | Medicaid | OR |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jfordyce1030020@oc.providencedirect.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
14600 NW Cornell Rd
Portland, OR 97229-5442
971 SW Walnut St
Hillsboro, OR 97123-5651
Phone (503) 640-5297
Hospital & facility affiliations
- Hillsboro Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Zest Family Medicine PLLC | Family | Current | Accepting new patients |
| Lifeworks NW | Current | Accepting new patients |
Locations
971 SW Walnut St
Hillsboro, OR 97123
Phone (503) 640-5297
5415 SW Westgate Dr
Portland, OR 97221
Phone (503) 645-9010
1201 N Lakeline Blvd
Ste 400
Cedar Park, TX 78613
Phone (512) 379-7272
Organizations & group practices 2
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.
-
- Mental Health Counselor
- Portland, OR
- NPI 1467408013
-
- Family Nurse Practitioner
- Cedar Park, TX
- NPI 1780221598
Hospital & facility affiliations 12
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Psychiatric Hospital
- Hillsboro, OR
- NPI 1073817714
-
- General Acute Care Hospital
- Hillsboro, OR
- NPI 1275591984
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615248000000",
"number": "1447736608",
"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"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "417 SW 117TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972255924",
"telephone_number": "503-216-8980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORDYCE",
"first_name": "JONATHAN",
"middle_name": "RYAN",
"name_prefix": "Mr.",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-11",
"last_updated": "2021-03-09",
"certification_date": "2021-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "AP137863",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500760115",
"state": "OR"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jfordyce1030020@oc.providencedirect.org",
"affiliation": "N",
"address_1": "417 SW 117th Ave",
"city": "Portland",
"state": "OR",
"country_code": "US",
"postal_code": "972255924",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Mar 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.