Jacqueline Abbott, DRPH, RDN, DOULA

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

715676 Issued in OR

Practice address

1511 Division St Ste 102
Oregon City, OR 97045

Phone

(503) 698-3928

Fax

(503) 698-4018

NPI assigned

Nov 29, 2005

Last updated

Nov 30, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Primary Care Group PCGroup PAC ID 0244125052, 44 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jacqueline.abbott.1@30939.direct.athenahealth.com

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.

• Northwest Primary Care Group PC

  • Family Medicine Physician
  • Portland, OR
  • NPI 1144319658
  Medicare reassignment Care Compare group NPD
• Northwest Primary Care Group PC

  • Family Medicine Physician
  • Milwaukie, OR
  • NPI 1801856737

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1477536902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2123 SYLVAN WAY",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "97068",
            "telephone_number": "503-819-8571",
            "fax_number": "503-652-5223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 DIVISION ST STE 102",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "97045",
            "telephone_number": "503-698-3928",
            "fax_number": "503-698-4018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABBOTT",
        "first_name": "JACQUELINE",
        "name_prefix": "Ms.",
        "credential": "DRPH, RDN, DOULA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-29",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "680",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "715676",
            "primary": true
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "OR",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Oregon City, OR
• Providers in Oregon City, OR by specialty
• Registered Dietitian in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.