NPIMap

Individual provider Active NPI

Jacquelyn Denise Adams, DNP, FNP

  • Adult Medicine Physician
  • Baker City, OR
National Provider Identifier
1710659628
Registry record updated Oct 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
202110723NP-PP Issued in OR
Practice address
3325 Pocahontas Rd
Baker City, OR 97814-1464
Phone
(541) 524-8000
Fax
(541) 524-7955
NPI assigned
Sep 29, 2021
Last updated
Oct 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 202110723NP-PP OR Primary

Addresses

Primary practice location

3325 Pocahontas Rd
Baker City, OR 97814-1464

Mailing address

3325 Pocahontas Rd
Baker City, OR 97814-1464
Phone (541) 519-5024

Other practice location 1

2970 N 3rd St
Baker City, OR 97814-1814
Phone (541) 519-5024

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220315002358 OR Practitioner - Nurse Practitioner 6507251279 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Alphonsus Medical Center Baker City IncGroup PAC ID 4981732518, shared by 3 NPIs, 15 clinicians

Practice addresses (Care Compare)

3325 Pocahontas Rd
Baker City, OR 97814-1464
Phone (541) 524-2965

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
202110723NP-PPORMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Medical Center Baker City, Inc CurrentSince Apr 25, 2022 Accepting new patients
Saint Alphonsus Medical Center Baker City, Inc CurrentSince Apr 25, 2022 Accepting new patients

Locations

3340 E Goldstone Dr
Meridian, ID 83642
Phone (208) 302-9342

3325 Pocahontas Rd
Baker City, OR 97814
Phone (541) 523-1797

Interoperability endpoints

  • Direct secure messaging: jadams1586217@direct.trinity-health.org

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1632873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1710659628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3325 POCAHONTAS RD",
            "city": "BAKER CITY",
            "state": "OR",
            "postal_code": "978141464",
            "telephone_number": "541-519-5024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3325 POCAHONTAS RD",
            "city": "BAKER CITY",
            "state": "OR",
            "postal_code": "978141464",
            "telephone_number": "541-524-8000",
            "fax_number": "541-524-7955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2970 N 3rd St",
            "address_purpose": "LOCATION",
            "city": "Baker City",
            "state": "OR",
            "postal_code": "978141814",
            "country_code": "US",
            "telephone_number": "541-519-5024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "JACQUELYN",
        "middle_name": "DENISE",
        "credential": "DNP, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-29",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "OR",
            "license": "202110723NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baker City, OR

Sources for this page

Verify at the official NPI Registry.