Individual provider Active NPI

Jillian Leigh Oppenheim, APRN BC FNP

  • Nurse Practitioner
  • Salem, MA
National Provider Identifier
1679765465
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
267909 Issued in MA
Practice address
564 Loring Ave
Salem, MA 01970-4276
Phone
(781) 631-2849
Fax
(864) 719-2725
NPI assigned
Aug 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 267909 MA Primary

Addresses

Primary practice location

564 Loring Ave
Salem, MA 01970-4276

Mailing address

564 Loring Ave
Salem, MA 01970-4276
Phone (781) 631-2849

Other identifiers 1

IdentifierTypeStateIssuer
0715522MedicaidMA

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)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Well Life Medical, PC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1679765465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "564 LORING AVE",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019704276",
            "telephone_number": "781-631-2849",
            "fax_number": "864-719-2725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "564 LORING AVE",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019704276",
            "telephone_number": "781-631-2849",
            "fax_number": "864-719-2725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OPPENHEIM",
        "first_name": "JILLIAN",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "APRN BC FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-15",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "267909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0715522",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; 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.