Active NPI
Jennifer Wynn, ARNP
- Family Nurse Practitioner
- Vancouver, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP60107358
- Practice address
- 200 NE Mother Joseph PL Ste 300
Vancouver, WA 98664 - Phone
- (360) 254-6161
- Fax
- (360) 449-1146
- NPI assigned
- Jul 22, 2008
- Last updated
- Aug 7, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 00157320 | WA | |
| Registered Nurse | 163W00000X | 200240758RN | OR | |
| Family Nurse Practitioner | 363LF0000X | 200950128NP | OR | |
| Family Nurse Practitioner | 363LF0000X | AP60107358 | WA | Primary |
Addresses
Primary practice location
200 NE Mother Joseph PL Ste 300
Vancouver, WA 98664
Mailing address
200 NE Mother Joseph PL Ste 210
Vancouver, WA 98664-3295
Phone (360) 254-6161
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0255099 | Other | WA | LABOR & INDUSTRIES |
| 9662735 | Medicaid | WA |
Other names 1
- Jennifer Plansky
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA, OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 N Ctr Court St
110 Rebound Sports Medicine
Portland, OR 97227-2104
Phone (503) 732-6863
200 NE Mother Joseph PL
Vancouver, WA 98664-3296
Phone (360) 254-6161
200 NE Mother Joseph PL
110 Rebound Orthopedics
Vancouver, WA 98664-3293
Phone (360) 254-6161
2121 NE 139TH St
300 Rebound
Vancouver, WA 98686-2316
Phone (360) 254-6161
2211 NE 139TH St
Legacy Salmon Creek Medical Center
Vancouver, WA 98686-2742
Phone (360) 487-1000
400 NE Mother Joseph PL
Peacehealth Southwest Medical Center
Vancouver, WA 98664-3200
Phone (360) 514-2000
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00157320 | WA | MD | Registered Nurse |
| 200950128NP | OR | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Surgical Specialists, P.C. | Current | Accepting new patients | |
| Northwest Surgical Specialists PC | Current | Accepting new patients | |
| J and D Physical Therapy Services | Past | Accepting new patients |
Locations
1 N Center Court St
Ste 11
Portland, OR 97227
Phone (503) 732-6863
1 N Center Court St
Ste 110
Portland, OR 97227
Phone (503) 732-6863
200 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2990
200 NE Mother Joseph Pl
Ste 210
Vancouver, WA 98664
Phone (360) 449-1145
200 NE Mother Joseph Pl
Ste 300
Vancouver, WA 98664
Phone (360) 256-4060
2121 NE 139th St
Ste 300
Vancouver, WA 98686
Interoperability endpoints
- jennifer.wynnarnp.p1@direct.reboundmd.nextgenshare.com
- jwynn21851@reboundmd.gardenplot.direct-ci.com
Organizations & group practices 3
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.
-
dba Rebound Orthopedics & Neurosurgical Specialists
- Orthopaedic Surgery Physician
- Portland, OR
- NPI 1730118803
WA
-
dba Rebound Physical Therapy Salmon Creek
- Durable Medical Equipment & Medical Supplies
- Vancouver, WA
- NPI 1821510306
-
dba Rebound Orthopedic Physical Therapy
- Physical Therapy Clinic/Center
- Portland, OR
- NPI 1134299951
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Legacy Salmon Creek Providers
- Clinic/Center
- Vancouver, WA
- NPI 1356357784
Hospital
-
- General Acute Care Hospital
- Vancouver, WA
- NPI 1700809829
-
dba PeaceHealth SW Heart & Vascular Center
- Cardiovascular Disease Physician
- Vancouver, WA
- NPI 1003194911
Hospital
-
dba PeaceHealth Southwest Medical Center
- General Acute Care Hospital
- Vancouver, WA
- NPI 1134178999
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533600000000",
"number": "1750546537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 NE MOTHER JOSEPH PL STE 210",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986643295",
"telephone_number": "360-254-6161",
"fax_number": "360-449-1146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 NE MOTHER JOSEPH PL STE 300",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "98664",
"telephone_number": "360-254-6161",
"fax_number": "360-449-1146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYNN",
"first_name": "JENNIFER",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-22",
"last_updated": "2018-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WA",
"license": "00157320",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OR",
"license": "200240758RN",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OR",
"license": "200950128NP",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WA",
"license": "AP60107358",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRIES",
"identifier": "0255099",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9662735",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "PLANSKY",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; 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.