Active NPI
Jenifer Lynn Folau
- Driver
- Coos Bay, OR
National Provider Identifier
1972091304
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- 74641487
- Practice address
- 63897 Wallace Rd
Coos Bay, OR 97420-8779 - Phone
- (541) 982-9793
- NPI assigned
- May 1, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | 74641487 | OR | Primary |
Addresses
Primary practice location
63897 Wallace Rd
Coos Bay, OR 97420-8779
Mailing address
63897 Wallace Rd
Coos Bay, OR 97420-8779
Phone (541) 982-9793
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
| License | State | Type | Specialty |
|---|---|---|---|
| 74641487 | OR | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525132800000",
"number": "1972091304",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "63897 WALLACE RD",
"city": "COOS BAY",
"state": "OR",
"postal_code": "974208779",
"telephone_number": "541-982-9793"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "63897 WALLACE RD",
"city": "COOS BAY",
"state": "OR",
"postal_code": "974208779",
"telephone_number": "541-982-9793"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOLAU",
"first_name": "JENIFER",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-01",
"last_updated": "2018-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "OR",
"license": "74641487",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 May 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.