Active NPI
Jenna Hannah Gaines, AGACNP
- Acute Care Nurse Practitioner
- Hillsboro, OR
National Provider Identifier
1518419704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 201809756NP-PP
- Practice address
- 335 SE 8TH Ave
Hillsboro, OR 97123-4246 - Phone
- (503) 681-1860
- Fax
- (503) 681-1606
- NPI assigned
- Nov 4, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 5009013 | NC | |
| Acute Care Nurse Practitioner | 363LA2100X | 201809756NP-PP | OR | Primary |
Addresses
Primary practice location
335 SE 8TH Ave
Hillsboro, OR 97123-4246
Mailing address
1400 SW 5TH Ave Ste 500
Portland, OR 97201-5537
Phone (503) 494-8417
Other practice location 1
Medical Center Blvd
Winston Salem, NC 27157
Phone (336) 716-2255
Other practice location 2
Medical Center Blvd
Winston Salem, NC 27157
Phone (336) 716-2255
Other practice location 3
9427 SW Barnes Rd Ste 495
Portland, OR 97225
Phone (503) 216-1661
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500759983 | Medicaid | OR |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jgaines1014527@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, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
335 SE 8TH Ave
Hillsboro, OR 97123-4246
Phone (503) 681-1111
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201809756NP-PP | OR | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Health & Services Oregon | Current | Accepting new patients | |
| Providence Health & Services - Oregon | Current | Accepting new patients | |
| Providence Health & Services - Oregon | Current | Accepting new patients | |
| Providence Health & Services - Oregon | Current | Accepting new patients | |
| Tuality Medical Group LLC | Current | Accepting new patients | |
| Providence Health & Services - Oregon | Current | Accepting new patients | |
| Tuality Medical Group LLC | Current | Accepting new patients |
Locations
335 SE 8th Ave
Hillsboro, OR 97123
Phone (503) 681-1111
1400 SW 5th Ave
Ste 500
Portland, OR 97201
9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234
4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111
9427 SW Barnes Rd
Ste 495
Portland, OR 97225
Phone (503) 216-0900
Interoperability endpoints
- jgaines168124@direct.ohsu.edu
Organizations & group practices 7
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.
-
- Internal Medicine Physician
- Hillsboro, OR
- NPI 1073929782
-
- General Acute Care Hospital
- Portland, OR
- NPI 1003991845
-
- General Acute Care Hospital
- Portland, OR
- NPI 1114015971
-
- Clinical Pathology Physician
- Portland, OR
- NPI 1740732650
-
- Clinical Pathology Physician
- Portland, OR
- NPI 1831641745
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Portland, OR
- NPI 1396818993
-
- Neurology Physician
- Hillsboro, OR
- NPI 1639690704
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": "1478217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703116800000",
"number": "1518419704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 SW 5TH AVE STE 500",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972015537",
"telephone_number": "503-494-8417",
"fax_number": "503-494-4455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "335 SE 8TH AVE",
"city": "HILLSBORO",
"state": "OR",
"postal_code": "971234246",
"telephone_number": "503-681-1860",
"fax_number": "503-681-1606"
}
],
"practiceLocations": [
{
"address_1": "Medical Center Blvd",
"address_purpose": "LOCATION",
"city": "Winston Salem",
"state": "NC",
"postal_code": "27157",
"country_code": "US",
"telephone_number": "336-716-2255",
"fax_number": "336-716-3202",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "Medical Center Blvd",
"address_purpose": "LOCATION",
"city": "Winston Salem",
"state": "NC",
"postal_code": "27157",
"country_code": "US",
"telephone_number": "336-716-2255",
"fax_number": "336-716-3202",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9427 SW Barnes Rd Ste 495",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "97225",
"country_code": "US",
"telephone_number": "503-216-1661",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GAINES",
"first_name": "JENNA",
"middle_name": "HANNAH",
"credential": "AGACNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-04",
"last_updated": "2023-12-21",
"certification_date": "2023-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NC",
"license": "5009013",
"primary": false
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "OR",
"license": "201809756NP-PP",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500759983",
"state": "OR"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jgaines1014527@oc.providencedirect.org",
"affiliation": "N",
"address_1": "9427 SW Barnes Rd Ste 495",
"city": "Portland",
"state": "OR",
"country_code": "US",
"postal_code": "97225",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Hillsboro, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; 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.