Individual provider Active NPI

Wilnise Jasmin, MD

  • Family Medicine Physician
  • Salem, OR
National Provider Identifier
1700204740
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
216513 Issued in MD
Practice address
2600 Center St NE
Salem, OR 97301-2682
Phone
(503) 510-2723
NPI assigned
Apr 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 216513 MD Primary

Addresses

Primary practice location

2600 Center St NE
Salem, OR 97301-2682

Mailing address

2600 Center St NE
Salem, OR 97301-2682
Phone (510) 503-2723

Other practice location 1

29398 Recovery Way
Junction City, OR 97448-8447
Phone (510) 503-2723

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241119004529 OR Practitioner - Family Practice 3971805904 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
216513MDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DHS/Office of Financial Services Irs/Eopc/BMRC/Eotc/Osh/Osh-P CurrentSince Oct 1, 2024 Accepting new patients

Locations

29398 Recovery Way
Junction City, OR 97448
Phone (503) 945-2800

2600 Center St NE
Salem, OR 97301
Phone (503) 945-2800

Interoperability endpoints

  • Direct secure messaging: wjasmin@direct.ccprovider.org

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": "1396742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1700204740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 CENTER ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012682",
            "telephone_number": "510-503-2723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 CENTER ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012682",
            "telephone_number": "503-510-2723"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29398 Recovery Way",
            "address_purpose": "LOCATION",
            "city": "Junction City",
            "state": "OR",
            "postal_code": "974488447",
            "country_code": "US",
            "telephone_number": "510-503-2723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JASMIN",
        "first_name": "WILNISE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-06",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "216513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.