NPIMap

Individual provider Active NPI

Jennifer L Willingham, M.D.

  • Family Medicine Physician
  • Scappoose, OR
National Provider Identifier
1972589976
Registry record updated May 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD181506 Issued in OR
Practice address
51377 SW Old Portland Rd
Scappoose, OR 97056-4023
Phone
(503) 418-4222
NPI assigned
Dec 21, 2005
Last updated
May 19, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0420010400 VT
Family Medicine Physician 207Q00000X MD181506 OR Primary

Addresses

Primary practice location

51377 SW Old Portland Rd
Scappoose, OR 97056-4023

Mailing address

51377 SW Old Portland Rd
Scappoose, OR 97056-4023
Phone (503) 418-4222

Other identifiers 4

IdentifierTypeStateIssuer
1008992MedicaidVT
365938OtherVTMVP
58976OtherVTBLUE CROSS BLUE SHIELD
58976OtherVTVERMONT MANAGED CARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170619002456 OR Practitioner - Family Practice 6406806728 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical School at San Antonio, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tuality Medical Group LLCGroup PAC ID 7416173414, 289 clinicians

Practice addresses (Care Compare)

335 SE 8TH Ave
Hillsboro, OR 97123-4246
Phone (503) 681-1111

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
139825CAMDMarriage & Family Therapist
MD181506ORMDFamily Medicine Physician
0420010400VTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Jun 1, 2017 Accepting new patients
University Professional Services CurrentSince Jun 1, 2017 Accepting new patients
Tuality Healthcare CurrentSince Jan 24, 2018 Accepting new patients
Tuality Medical Group LLC CurrentSince Dec 1, 2024 Accepting new patients
Tuality Healthcare Family Medicine Current Accepting new patients
Tuality Healthcare Current Accepting new patients
University Professional Services Current Accepting new patients
Oregon Health & Science University CurrentSince Jun 1, 2017 Accepting new patients
Oregon Health & Science University CurrentSince Jun 1, 2017 Accepting new patients
Tuality Medical Group LLC CurrentSince Jan 24, 2018 Accepting new patients
Tuality Healthcare CurrentSince Jan 24, 2018 Accepting new patients
Community Health Centers of Burlington Inc Past Accepting new patients
University of Vermont Medical Center Inc Family Medicine Past Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

335 SE 8th Ave
Hillsboro, OR 97123
Phone (503) 681-1111

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

3930 SE Division St
Portland, OR 97202
Phone (503) 418-3900

51377 SW Old Portland Rd
Scappoose, OR 97056
Phone (503) 418-4222

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: jwillingham101734@direct.ohsu.edu

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495152000000",
    "number": "1972589976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51377 SW OLD PORTLAND RD",
            "city": "SCAPPOOSE",
            "state": "OR",
            "postal_code": "970564023",
            "telephone_number": "503-418-4222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51377 SW OLD PORTLAND RD",
            "city": "SCAPPOOSE",
            "state": "OR",
            "postal_code": "970564023",
            "telephone_number": "503-418-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLINGHAM",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-21",
        "last_updated": "2017-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VT",
            "license": "0420010400",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD181506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1008992",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "365938",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "58976",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VERMONT MANAGED CARE",
            "identifier": "58976",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scappoose, OR

Sources for this page

Verify at the official NPI Registry.