Individual provider Active NPI

Joelene Peasley, RN, MSN, FNP-C

  • Family Nurse Practitioner
  • La Grande, OR
National Provider Identifier
1700808706
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201050168NP Issued in OR
Practice address
2301 Cove Ave
La Grande, OR 97850-3906
Phone
(541) 962-8824
Fax
(541) 963-0520
NPI assigned
Jul 25, 2006
Last updated
Apr 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 099000698RN OR
Family Nurse Practitioner 363LF0000X 201050168NP OR Primary

Addresses

Primary practice location

2301 Cove Ave
La Grande, OR 97850-3906

Mailing address

2301 Cove Ave
La Grande, OR 97850-3906
Phone (541) 962-8800

Other identifiers 3

IdentifierTypeStateIssuer
1700808706OtherORBLUE CROSS
500644966MedicaidOR
R171365OtherORMEDICARE

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120905000262 OR Practitioner - Nurse Practitioner 2365699964 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
099000698RNORMDCommunity Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Access Sleep MD Professional Corporation Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1700808706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 COVE AVE",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978503906",
            "telephone_number": "541-962-8800",
            "fax_number": "541-963-5272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 COVE AVE",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978503906",
            "telephone_number": "541-962-8824",
            "fax_number": "541-963-0520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEASLEY",
        "first_name": "JOELENE",
        "name_prefix": "Mrs.",
        "credential": "RN, MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "OR",
            "license": "099000698RN",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201050168NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "1700808706",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500644966",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "R171365",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grande, OR

Sources for this page

Verify at the official NPI Registry.