Individual provider Active NPI

Jennifer Lynn Dannenbring, DPT

  • Physical Therapist
  • Coos Bay, OR
National Provider Identifier
1831893775
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
64885 Issued in OR
Practice address
2645 N 17TH St
Coos Bay, OR 97420-2134
Phone
(541) 266-3658
Fax
(541) 267-5395
NPI assigned
Mar 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 64885 OR Primary

Addresses

Primary practice location

2645 N 17TH St
Coos Bay, OR 97420-2134

Mailing address

2645 N 17TH St
Coos Bay, OR 97420-2134
Phone (541) 266-3658

Other names 1

  • Jennifer Lynn Anderson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230607001741 OR Practitioner - Physical Therapist in Private Practice 6305203332 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coquille Valley HealthGroup PAC ID 2567902182, 20 clinicians

Practice addresses (Care Compare)

2645 N 17TH St
Coos Bay, OR 97420-2134
Phone (541) 266-3658

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
64885ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Coquille Valley Health CurrentSince Dec 1, 2024 Accepting new patients
Coquille Valley Health CurrentSince Dec 1, 2024 Accepting new patients
South Coast Orthopaedic Associates, PC CurrentSince Apr 17, 2023 Accepting new patients
Coquille Valley Health Past Accepting new patients

Locations

2699 N 17th St
Coos Bay, OR 97420
Phone (541) 266-3600

2645 N 17th St
Coos Bay, OR 97420
Phone (541) 266-3658

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1831893775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2645 N 17TH ST",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202134",
            "telephone_number": "541-266-3658",
            "fax_number": "541-267-5395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2645 N 17TH ST",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202134",
            "telephone_number": "541-266-3658",
            "fax_number": "541-267-5395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANNENBRING",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "64885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "ANDERSON",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Coos Bay, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.