Individual provider Active NPI

Jenifer L McKenney, FNP

  • Obstetrics & Gynecology Nurse Practitioner
  • Bangor, ME
National Provider Identifier
1992069058
Registry record updated May 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
CNP121061 Issued in ME
Practice address
417 State Street
Webber West Suite 141
Bangor, ME 04401
Phone
(207) 973-4670
Fax
(207) 973-4669
NPI assigned
Jul 3, 2012
Last updated
May 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X CNP121061 ME Primary
Family Nurse Practitioner 363LF0000X CNP121061 ME

Addresses

Primary practice location

417 State Street
Webber West Suite 141
Bangor, ME 04401

Mailing address

43 Whiting Hill Rd Ste 300
Brewer, ME 04412-1006
Phone (207) 973-4670

Other names 1

  • Jenifer M Piper Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120927000578 ME Practitioner - Nurse Practitioner 8123277688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Maine Medical CenterGroup PAC ID 2062315161, 659 clinicians

Practice addresses (Care Compare)

417 State St
Bangor, ME 04401-6634

489 State St
Bangor, ME 04401-6616
Phone (207) 973-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.1 of 100Reported as group
Quality
64.8
Promoting interoperability
96
Improvement activities
40
Cost
68.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP121061MEMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Maine Medical Center CurrentSince Jul 1, 2017 Accepting new patients
Eastern Maine Medical Center CurrentSince Jul 1, 2017 Accepting new patients

Locations

417 State St
Ste 141
Bangor, ME 04401
Phone (207) 973-4670

417 State St
Ste 442
Bangor, ME 04401
Phone (207) 945-6206

931 Union St
Fl 3
Bangor, ME 04401

489 State St
Bangor, ME 04401
Phone (207) 973-8837

417 State St
Bangor, ME 04401
Phone (207) 942-6096

43 Whiting Hill Rd
Brewer, ME 04412
Phone (207) 973-5000

43 Whiting Hill Rd
Ste 300
Brewer, ME 04412
Phone (207) 973-5000

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1341273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589500800000",
    "number": "1992069058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 WHITING HILL RD STE 300",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121006",
            "telephone_number": "207-973-4670",
            "fax_number": "207-973-4669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 STATE STREET",
            "address_2": "WEBBER WEST SUITE 141",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "04401",
            "telephone_number": "207-973-4670",
            "fax_number": "207-973-4669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENNEY",
        "first_name": "JENIFER",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-03",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "ME",
            "license": "CNP121061",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP121061",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENIFER",
            "last_name": "PIPER",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.