Active NPI
Jennifer Anne Jenkins, ARNP, PHMNP-BC
- Psychiatric/Mental Health Nurse Practitioner
- Portland, OR
National Provider Identifier
1922573658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 202108216NP-PP
- Practice address
- 33 NW Broadway
Portland, OR 97209-3580 - Phone
- (503) 228-7134
- NPI assigned
- Oct 9, 2018
- Last updated
- Jun 5, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN60666821 | WA | |
| Registered Nurse | 163W00000X | 202106913RN | OR | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | AP60993254 | WA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | AP60993254 | WA | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 202108216NP-PP | OR | Primary |
Addresses
Primary practice location
33 NW Broadway
Portland, OR 97209-3580
Mailing address
232 NW 6TH Ave
Portland, OR 97209-3609
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922573658 | Medicaid | WA |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 202106913RN | OR | MD | Registered Nurse |
| 202108216NP-PP | OR | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Narrative | Multi-Specialty | Current | Accepting new patients |
Locations
8935 SW Center St
Tigard, OR 97223
Phone (503) 726-3732
8915 SW Center St
Tigard, OR 97223
Phone (503) 726-3698
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Tigard, OR
- NPI 1265595664
Multi-Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717545600000",
"number": "1922573658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "232 NW 6TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972093609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33 NW BROADWAY",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972093580",
"telephone_number": "503-228-7134"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS",
"first_name": "JENNIFER",
"middle_name": "ANNE",
"credential": "ARNP, PHMNP-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-09",
"last_updated": "2024-06-05",
"certification_date": "2024-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WA",
"license": "RN60666821",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OR",
"license": "202106913RN",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "WA",
"license": "AP60993254",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "WA",
"license": "AP60993254",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "OR",
"license": "202108216NP-PP",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1922573658",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.