Jacklynn Crump, FNP-BC, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

201902794NP-PP Issued in OR

Practice address

258 SW 5TH St Ste 2
Redmond, OR 97756-2150

Phone

(541) 203-0771

Fax

(458) 206-7385

NPI assigned

Apr 10, 2013

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

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jcrump680759@direct.ochin.org

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.

• Integrative Behavioral Health and Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Redmond, OR
  • NPI 1376320440

  Psychiatric/Mental Health, Adult

  Medicare reassignment NPD Authorized official
• Life Works of Central Oregon, LLC

  • Professional Counselor
  • Bend, OR
  • NPI 1225169378

  Psychiatric/Mental Health, Child & Adolescent

  NPD (past)

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

{
    "created_epoch": "1365552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1861835654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 SW 5TH ST STE 2",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977562150",
            "telephone_number": "541-203-0771",
            "fax_number": "458-206-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 SW 5TH ST STE 2",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977562150",
            "telephone_number": "541-203-0771",
            "fax_number": "458-206-7385"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "850 SW 4th St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Madras",
            "state": "OR",
            "postal_code": "977419629",
            "country_code": "US",
            "telephone_number": "541-475-6575",
            "fax_number": "541-475-6196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUMP",
        "first_name": "JACKLYNN",
        "name_prefix": "Ms.",
        "credential": "FNP-BC, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-10",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201902794NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hanna Crews, SLP
• Abraham Crockett, RN
• Rodney J Cross, D.C.
• Steven W Cross, M.D.
• Ellen Crownover, LMT
• Maricella Cruz, LMT
• Chrystail Cuellar
• Susan Elizabeth Culbertson-Holmes, OT
• Emily Culbertson, CADC II, QMHA II
• Hannah Cuniff, BSW

• Psychiatric/Mental Health Nurse Practitioner in Redmond, OR
• Providers in Redmond, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; 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.

Verify at the official NPI Registry.