Individual provider Active NPI

Jeffrey Berner, R.N.

  • Emergency Registered Nurse
  • Vancouver, WA
National Provider Identifier
1578793329
Registry record updated Jul 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Registered NurseTaxonomy code 163WE0003X
License
200542648RN Issued in OR
Practice address
400 NE Mother Joseph PL
Vancouver, WA 98664-3200
Phone
(360) 514-2064
NPI assigned
Jul 14, 2009
Last updated
Jul 14, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X 200542648RN OR Primary

Addresses

Primary practice location

400 NE Mother Joseph PL
Vancouver, WA 98664-3200

Mailing address

3095 NW Gravenstein St
Camas, WA 98607-7377
Phone (360) 834-0418

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20110620000722 WA Practitioner - Nurse Practitioner 3072791102 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Washington University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PeacehealthGroup PAC ID 9537073960, 292 clinicians

Practice addresses (Care Compare)

2979 Squalicum Pkwy
Suite 101
Bellingham, WA 98225-1813
Phone (360) 756-6800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200542648RNORMDEmergency Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth CurrentSince Jun 1, 2011 Accepting new patients
Peacehealth CurrentSince Jun 1, 2011 Accepting new patients
Peacehealth CurrentSince Aug 23, 2024 Accepting new patients

Locations

2979 Squalicum Pkwy
Ste 101
Bellingham, WA 98225
Phone (360) 788-6934

3015 Squalicum Pkwy
Ste 100
Bellingham, WA 98225
Phone (360) 715-4186

3015 Squalicum Pkwy
Ste 200
Bellingham, WA 98225
Phone (360) 733-2092

400 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2000

Interoperability endpoints

  • Direct secure messaging: jberner55837@direct.peacehealth.org

Organizations & group practices 3

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247529600000",
    "number": "1578793329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3095 NW GRAVENSTEIN ST",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986077377",
            "telephone_number": "360-834-0418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 NE MOTHER JOSEPH PL",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643200",
            "telephone_number": "360-514-2064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNER",
        "first_name": "JEFFREY",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-14",
        "last_updated": "2009-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "OR",
            "license": "200542648RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.