Jennie Smith

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

000028103N1 Issued in OR

Practice address

1270 Kotnum Road
Warm Springs Health and Wellness Center
Warm Springs, OR 97741

Phone

(541) 553-2478

NPI assigned

Oct 2, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Confederated Tribes of the Warm Springs Reservation of Oregon

  • Clinic/Center
  • Warm Springs, OR
  • NPI 1700027927
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669566105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1209",
            "address_2": "WARM SPRINGS HEALTH AND WELLNESS CENTER",
            "city": "WARM SPRINGS",
            "state": "OR",
            "postal_code": "97741",
            "telephone_number": "541-553-2478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 KOTNUM ROAD",
            "address_2": "WARM SPRINGS HEALTH AND WELLNESS CENTER",
            "city": "WARM SPRINGS",
            "state": "OR",
            "postal_code": "97741",
            "telephone_number": "541-553-2478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JENNIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "000028103N1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Marie Schrand, PHARM.D., BCPS
• Jane Seaders, RN
• Francisco Silva III
• Juanita Ruth Simpson, R.D.H.
• Cheryl Lynn Sixkiller, D.D.S
• Emerson George Squiemphen
• Constance Jean Street, RN
• Denise Swift, R.N.
• Vincent Joaquin Tavalez, PHARMD
• The Confederated Tribes of the Warm Springs Reservation of Oregon

• Nurse Practitioner in Warm Springs, OR
• Providers in Warm Springs, OR by specialty
• Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.