Individual provider Active NPI

Jill Renee McLean, DOULA

  • Doula
  • Salem, OR
National Provider Identifier
1538779947
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DoulaTaxonomy code 374J00000X
License
THW000104104 Issued in OR
Practice address
5068 Summerfield Dr SE
Salem, OR 97306-1706
Phone
(503) 999-3253
NPI assigned
Jul 31, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Doula 374J00000X THW000104104 OR Primary

Addresses

Primary practice location

5068 Summerfield Dr SE
Salem, OR 97306-1706

Mailing address

5068 Summerfield Dr SE
Salem, OR 97306-1706
Phone (503) 999-3253

Other identifiers 1

IdentifierTypeStateIssuer
THW000104104MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
THW000104104ORMDDoula

NPI Registry JSON

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

{
    "created_epoch": "1596153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1538779947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5068 SUMMERFIELD DR SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973061706",
            "telephone_number": "503-999-3253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5068 SUMMERFIELD DR SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973061706",
            "telephone_number": "503-999-3253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEAN",
        "first_name": "JILL",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "DOULA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-31",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "OR",
            "license": "THW000104104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "THW000104104",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.