Active NPI
Jennifer Ann Fletcher, D.C., LAC.
- Chiropractor
- Portland, OR
National Provider Identifier
1487608147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2317
- Practice address
- 0224 SW Hamilton St Ste 101
Portland, OR 97239-6418 - Phone
- (502) 222-5005
- Fax
- (800) 491-8171
- NPI assigned
- May 19, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC00250 | OR | |
| Chiropractor | 111N00000X | 2317 | OR | Primary |
Addresses
Primary practice location
0224 SW Hamilton St Ste 101
Portland, OR 97239-6418
Mailing address
0224 SW Hamilton St Ste 101
Portland, OR 97239-6418
Phone (502) 222-5005
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 051297 | Other | OR | CONTRACTOR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210527000545 | OR | Practitioner - Chiropractic | 0941609705 | Practice locations: Portland, OR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AC00250 | OR | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1501459200000",
"number": "1487608147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "0224 SW HAMILTON ST STE 101",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972396418",
"telephone_number": "502-222-5005",
"fax_number": "800-491-8171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "0224 SW HAMILTON ST STE 101",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972396418",
"telephone_number": "502-222-5005",
"fax_number": "800-491-8171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLETCHER",
"first_name": "JENNIFER",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "D.C., LAC.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-19",
"last_updated": "2017-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "OR",
"license": "AC00250",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OR",
"license": "2317",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONTRACTOR",
"identifier": "051297",
"state": "OR"
}
],
"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 Jul 31, 2017; 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.