Individual provider Active NPI

Jennifer Robin Smith, FNP

  • Family Nurse Practitioner
  • Salem, OR
National Provider Identifier
1497270268
Registry record updated Aug 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201706184NP-PP Issued in OR
Practice address
1793 13TH St SE
Salem, OR 97302-2541
Phone
(866) 599-3376
NPI assigned
Aug 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201706184NP-PP OR Primary

Addresses

Primary practice location

1793 13TH St SE
Salem, OR 97302-2541

Mailing address

19682 SW Murphy St
Aloha, OR 97078-4331
Phone (503) 975-4931

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171106002302 OR Practitioner - Nurse Practitioner 3577829688 Reassigns benefits to 1 organization
I20171214001318 WA Practitioner - Nurse Practitioner 3577829688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Silver Falls Dermatology LLCGroup PAC ID 5890863492, 100 clinicians

Practice addresses (Care Compare)

1020 Anderson Dr
Suite 204
Aberdeen, WA 98520-1055
Phone (866) 599-3376

1793 13TH St SE
Salem, OR 97302-2541
Phone (503) 362-8385

Merit-based Incentive Payment System (MIPS)

Final score
98.3 of 100Reported as individual
Promoting interoperability
98
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201706184NP-PPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Falls Dermatology, LLC CurrentSince Oct 2, 2017 Accepting new patients
Silver Falls Dermatology, LLC CurrentSince Oct 2, 2017 Accepting new patients

Locations

1390 Waverly Dr SE
Ste 100
Albany, OR 97322

1390 Waverly Dr SE
Albany, OR 97322
Phone (541) 967-8385

375 Park Ave
Ste 5
Coos Bay, OR 97420
Phone (541) 267-7543

2358 NW Kings Blvd
Ste 100
Corvallis, OR 97330
Phone (541) 368-5986

831 NW Council Dr
Ste 301
Gresham, OR 97030
Phone (503) 661-2577

375 SE Norton Ln
Ste C
McMinnville, OR 97128
Phone (503) 472-8162

904 SW Bay St
Newport, OR 97365
Phone (541) 683-2020

1793 13th St SE
Salem, OR 97302
Phone 50336283851283

1020 Anderson Dr
Ste 204
Aberdeen, WA 98520
Phone (360) 986-3004

1515 116th Ave NE
Ste 307
Bellevue, WA 98004
Phone (425) 999-2628

1106 Douglas St
Ste F
Longview, WA 98632
Phone (360) 636-4500

3825 Martin Way E
Ste 104
Olympia, WA 98506
Phone (971) 915-8579

Interoperability endpoints

  • Direct secure messaging: jennifersmith@frontierdermpartners.emadirect.md

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.

NPI Registry JSON

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

{
    "created_epoch": "1502582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502582400000",
    "number": "1497270268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19682 SW MURPHY ST",
            "city": "ALOHA",
            "state": "OR",
            "postal_code": "970784331",
            "telephone_number": "503-975-4931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1793 13TH ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022541",
            "telephone_number": "866-599-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JENNIFER",
        "middle_name": "ROBIN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-13",
        "last_updated": "2017-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201706184NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.