Jade Alyxandra Pettit, RN

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

201141655RN Issued in OR

Practice address

55930 Blue Eagle Rd
Bend, OR 97707-2369

Phone

(541) 640-2518

Fax

(541) 550-2919

NPI assigned

Feb 5, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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.

• Home Health of Northwest, LLC

  • Home Health Agency
  • Bend, OR
  • NPI 1609548031
  NPD

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

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1770346504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55930 BLUE EAGLE RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977072369",
            "telephone_number": "541-640-2518",
            "fax_number": "541-550-2919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55930 BLUE EAGLE RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977072369",
            "telephone_number": "541-640-2518",
            "fax_number": "541-550-2919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIT",
        "first_name": "JADE",
        "middle_name": "ALYXANDRA",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "OR",
            "license": "201141655RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nickolas Petragallo, CRM/PSS
• Jacqueline Petrovic
• Sheyanne L Petrovich, LCSW
• Kevin Richard Pett, PHD, DAOM
• Lorri M Petterson, RN
• Claire Petzinger, PA-C
• Pfeifer & Associates
• Sally L Pfeifer, CACD I
• Bradley Andrew Pfeiffer, D.C.
• Robin Ann Pfeiffer, MSW, LCSW

• Home Health Registered Nurse in Bend, OR
• Providers in Bend, OR by specialty
• Home Health Registered Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.