Active NPI
Jeffrey F Jarvi, PAC
- Medical Physician Assistant
- Salem, OR
National Provider Identifier
1811981020
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA00423
- Practice address
- 2478 13TH St SE
Salem, OR 97302-2546 - Phone
- (503) 362-2481
- Fax
- (503) 371-7803
- NPI assigned
- Sep 1, 2005
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA00423 | OR | Primary |
| Pediatric Clinical Nurse Specialist | 364SP0200X | PA00423 | OR |
Addresses
Primary practice location
2478 13TH St SE
Salem, OR 97302-2546
Mailing address
2478 13TH St SE
Salem, OR 97302-2546
Phone (503) 362-2481
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 032458 | Medicaid | OR |
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA00423 | OR | MD | Pediatric Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208908800000",
"number": "1811981020",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2478 13TH ST SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973022546",
"telephone_number": "503-362-2481",
"fax_number": "503-371-7803"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2478 13TH ST SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973022546",
"telephone_number": "503-362-2481",
"fax_number": "503-371-7803"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JARVI",
"first_name": "JEFFREY",
"middle_name": "F",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-01",
"last_updated": "2008-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "OR",
"license": "PA00423",
"primary": true
},
{
"code": "364SP0200X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Pediatrics",
"state": "OR",
"license": "PA00423",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "032458",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.