Individual provider Active NPI

Jenna Susanne Wertheim, RN

  • Registered Nurse
  • West Linn, OR
National Provider Identifier
1811478928
Registry record updated Aug 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
201806456RN Issued in OR
Practice address
2558 Troy CT
West Linn, OR 97068-7306
Phone
(180) 525-9755
NPI assigned
Aug 27, 2018
Last updated
Aug 27, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 201806456RN OR Primary

Addresses

Primary practice location

2558 Troy CT
West Linn, OR 97068-7306

Mailing address

2558 Troy CT
West Linn, OR 97068-7306
Phone (805) 259-7554

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
201806456RNORMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1811478928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2558 TROY CT",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970687306",
            "telephone_number": "805-259-7554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2558 TROY CT",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970687306",
            "telephone_number": "180-525-9755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERTHEIM",
        "first_name": "JENNA",
        "middle_name": "SUSANNE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-27",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201806456RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Linn, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2018; 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.