Jean-Claude Kleber Provost, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

200350102NP FNP-PP Issued in OR

Practice address

5100 S Macadam Ave Ste 200
Portland, OR 97239-3827

Phone

(971) 202-5500

Fax

(971) 202-5555

NPI assigned

May 23, 2006

Last updated

Dec 7, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Housecall Providers PCGroup PAC ID 7113297789, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jeanclaudeprovost@hpi.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Housecall Providers, PC

  • Geriatric Medicine (Family Medicine) Physician
  • Portland, OR
  • NPI 1396274817
  Medicare reassignment Care Compare group NPD
• Housecall Providers Inc

  • Geriatric Medicine (Family Medicine) Physician
  • Portland, OR
  • NPI 1619915774
  NPD
• Housecall Providers, PC

  • Family Medicine Physician
  • Portland, OR
  • NPI 1770071862
  NPD

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1578518080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 S MACADAM AVE STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393827",
            "telephone_number": "971-202-5500",
            "fax_number": "971-202-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 S MACADAM AVE STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393827",
            "telephone_number": "971-202-5500",
            "fax_number": "971-202-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVOST",
        "first_name": "JEAN-CLAUDE",
        "middle_name": "KLEBER",
        "name_prefix": "Mr.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "200350102NP FNP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Providence St Vincent Medical Center (Providence Integrative Medicine West)
• Providence St Vincent Medical Center (Infectious Disease Consultants)
• Providence St Vincent Medical Center (Providence Hospitalists West)
• Providence St. Vincent Medical Center
• Rebecca L Provorse, ND, LAC
• Ralph Merrill Prows, M.D.
• Jonathan R Prue, LMT
• Amy Kathleen Pruett, DMD
• David Rollins Pruett, M.D.
• Jill Elizabeth Pruett, MD

• Family Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; 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.

Verify at the official NPI Registry.