Active NPI
John Njenga, PA, MS, MHS, MPH
- Family Medicine Physician
- Portland, OR
National Provider Identifier
1982888376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- OR01379
- Practice address
- 12710 SE Division St
Portland, OR 97236-3134 - Phone
- (503) 988-5578
- NPI assigned
- Dec 21, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | OR01379 | OR | Primary |
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | MA053309 | PA |
Addresses
Primary practice location
12710 SE Division St
Portland, OR 97236-3134
Mailing address
12710 SE Division St
Portland, OR 97236-3134
Phone (503) 988-5578
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OR01379 | Other | OR | OREGON MEDICAL BOARD |
| C03762 | Other | MD | MARYLAND MEDICAL BOARD |
| PA601442006 | Other | OR | WASHINGTON BOARD OF MEDICINE |
| MA053309 | Other | PA | PENNSYLVANIA MEDICAL BOARD |
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)
- Enrolled
- Credentials
- Master of Science, Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OR01379 | OR | MD | Family Medicine Physician |
| MA053309 | PA | MD | Endocrinology, Diabetes & Metabolism Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392681600000",
"number": "1982888376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12710 SE DIVISION ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972363134",
"telephone_number": "503-988-5578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12710 SE DIVISION ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972363134",
"telephone_number": "503-988-5578"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NJENGA",
"first_name": "JOHN",
"credential": "PA, MS, MHS, MPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-21",
"last_updated": "2014-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "OR01379",
"primary": true
},
{
"code": "207RE0101X",
"taxonomy_group": "",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": "PA",
"license": "MA053309",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OREGON MEDICAL BOARD",
"identifier": "OR01379",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MARYLAND MEDICAL BOARD",
"identifier": "C03762",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON BOARD OF MEDICINE",
"identifier": "PA601442006",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PENNSYLVANIA MEDICAL BOARD",
"identifier": "MA053309",
"state": "PA"
}
],
"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 Feb 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.