Active NPI
Jon Martin Winjum, MD
- Family Medicine Physician
- Oregon City, OR
National Provider Identifier
1730156639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD20031
- Practice address
- 1420 John Adams St
Oregon City, OR 97045-1609 - Phone
- (503) 656-1484
- Fax
- (503) 650-1976
- NPI assigned
- Mar 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD20031 | OR | Primary |
Addresses
Primary practice location
1420 John Adams St
Oregon City, OR 97045-1609
Mailing address
1420 John Adams St
Oregon City, OR 97045-1609
Phone (503) 656-1484
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 082987 | Medicaid | OR |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Iowa, RJ & L Carver College of Medicine, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1420 John Adams St
Oregon City, OR 97045-1609
Phone (503) 656-1484
Hospital & facility affiliations
- Providence Home Health
- Providence Hospice
- Providence Willamette Falls Medical Center
- Providence Milwaukie Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD20031 | OR | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Praxis Health, PC | Current | Accepting new patients | |
| Praxis Health, PC | Family Medicine | Current | Accepting new patients |
Locations
4510 SW Hall Blvd
Beaverton, OR 97005
Phone (503) 644-1171
1420 John Adams St
Oregon City, OR 97045
Phone (503) 655-7235
Interoperability endpoints
- jwinjum134229@oc.providencedirect.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 and National Provider Directory roles.
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Providence Medical Group
- Clinic/Center
- Portland, OR
- NPI 1326272741
Hospital
-
dba Providence Willamette Falls Medical Center
- General Acute Care Hospital
- Oregon City, OR
- NPI 1912282369
-
dba Providence Hospice
- Community Based Hospice Care Agency
- Portland, OR
- NPI 1205924313
-
dba Providence Milwaukie Hospital
- General Acute Care Hospital
- Milwaukie, OR
- NPI 1366536963
-
dba Providence Home Health
- Home Health Agency
- Portland, OR
- NPI 1790873461
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191196800000",
"number": "1730156639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1420 JOHN ADAMS ST",
"city": "OREGON CITY",
"state": "OR",
"postal_code": "970451609",
"telephone_number": "503-656-1484",
"fax_number": "503-650-1976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1420 JOHN ADAMS ST",
"city": "OREGON CITY",
"state": "OR",
"postal_code": "970451609",
"telephone_number": "503-656-1484",
"fax_number": "503-650-1976"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WINJUM",
"first_name": "JON",
"middle_name": "MARTIN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-01",
"last_updated": "2007-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD20031",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "082987",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oregon City, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.