Jennifer O'Donnell, RN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP60934049 Issued in WA

Practice address

1615 Delaware St
Longview, WA 98632-2367

Phone

(360) 816-5706

Fax

(360) 696-5038

NPI assigned

Sep 7, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jodonnell75332@direct.peacehealth.org

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.

• Peacehealth

  dba PeaceHealth Southwest Medical Center

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1134178999
  Medicare reassignment NPD
• Peacehealth

  dba St. John Medical Center - PeaceHealth Medical Group

  • Multi-Specialty Clinic/Center
  • Longview, WA
  • NPI 1720056187
  Medicare reassignment NPD
• CRM Physicians, LLC

  dba Ascent Healthcare

  • Internal Medicine Physician
  • Beaverton, OR
  • NPI 1952674996
  Medicare reassignment
• Peacehealth

  dba PeaceHealth SW Heart & Vascular Center

  • Cardiovascular Disease Physician
  • Vancouver, WA
  • NPI 1003194911
  NPD
• Peacehealth

  dba St. John Medical Center - Outpatient Therapy

  • Physical Therapist
  • Longview, WA
  • NPI 1275501538
  NPD (past)
• Mark W Cheng LLC

  • Physical Medicine & Rehabilitation Physician
  • Portland, OR
  • NPI 1497251904
  NPD (past)

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1568919694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1472 BELLE CENTER RD",
            "city": "WASHOUGAL",
            "state": "WA",
            "postal_code": "986711111",
            "telephone_number": "503-887-7588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 DELAWARE ST",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322367",
            "telephone_number": "360-816-5706",
            "fax_number": "360-696-5038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1472 Belle Center Rd",
            "address_purpose": "LOCATION",
            "city": "Washougal",
            "state": "WA",
            "postal_code": "986717536",
            "country_code": "US",
            "telephone_number": "503-887-7588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "JENNIFER",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-07",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201705913RN",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60454019",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "201901742NP-PP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60934049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "jodonnell@peacehealth.org",
            "affiliation": "N",
            "address_1": "1615 Delaware St",
            "city": "Longview",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986322367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mildred M Nyberg
• Julie Nye, RN
• Elizabeth Kay O'Brien
• Priyanka Shah O'Brien, M.D.
• Carolyn Julia O'Day, LCSW
• Emily Shea O'Gorman
• Gregory Thomas O'Neal, M.S., D.M.H.P
• Gene M O'Neill, MSW
• Obermeyer & Schrepel Hearing Aid Specialist LLC
• George Frederick Obermeyer

• Nurse Practitioner in Longview, WA
• Providers in Longview, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.