Individual provider Active NPI

Jenna Kriegshauser, LPN

  • Licensed Practical Nurse
  • Salem, OR
National Provider Identifier
1942720743
Registry record updated Jun 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
201391721 Issued in OR
Practice address
3871 Fairview Industrial Dr SE
Salem, OR 97302-1180
Phone
(503) 391-9762
NPI assigned
Jun 22, 2017
Last updated
Jun 22, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 201391721 OR Primary

Addresses

Primary practice location

3871 Fairview Industrial Dr SE
Salem, OR 97302-1180

Mailing address

150 Indian Oak CT Unit 9
Molalla, OR 97038-8342

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

State licenses

LicenseStateTypeSpecialty
201391721ORMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Willamette Valley Treatment Center Licensed Practical Nurse Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498089600000",
    "number": "1942720743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 INDIAN OAK CT UNIT 9",
            "city": "MOLALLA",
            "state": "OR",
            "postal_code": "970388342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3871 FAIRVIEW INDUSTRIAL DR SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973021180",
            "telephone_number": "503-391-9762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIEGSHAUSER",
        "first_name": "JENNA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-22",
        "last_updated": "2017-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OR",
            "license": "201391721",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 22, 2017; 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.