Individual provider Active NPI

Jennifer E Feeney, ANP

  • Family Nurse Practitioner
  • Portland, OR
National Provider Identifier
1992259709
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10027852 Issued in OR
Practice address
501 N Graham St Ste 550
Portland, OR 97227-2010
Phone
(503) 284-5220
Fax
(503) 284-4971
NPI assigned
Aug 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 10027852 OR Primary
Family Nurse Practitioner 363LF0000X 112965 AK

Addresses

Primary practice location

501 N Graham St Ste 550
Portland, OR 97227-2010

Mailing address

541 NE 20TH Ave Ste 225
Portland, OR 97232-2895
Phone (503) 963-2801

Other identifiers 2

IdentifierTypeStateIssuer
95010242MedicaidCA
K167844MedicaidAK

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cc_otoc_obgyn_north_front_desk_pool12223217@oc.providencedirect.org The Oregon Clinic PC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200828001815 CA Practitioner - Nurse Practitioner 3274811880 Reassigns benefits to 3 organizations
I20241023004256 OR Practitioner - Nurse Practitioner 3274811880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Oregon Clinic, PCGroup PAC ID 2860390408, 353 clinicians

Practice addresses (Care Compare)

501 N Graham St
Suite 550
Portland, OR 97227-2010
Phone (503) 284-5220

5050 NE Hoyt
Suite 655
Portland, OR 97213-2990
Phone (503) 239-6673

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Capital OB/GYN, Inc. CurrentSince May 8, 2020 Accepting new patients
Regents of the University of California CurrentSince Feb 6, 2023 Accepting new patients
Regents of the Univ of Ca CurrentSince Aug 27, 2023 Accepting new patients
Regents of the Univ of Ca CurrentSince Aug 27, 2023 Accepting new patients
Regents of the University of California CurrentSince Feb 6, 2023 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients

Locations

2660 W Covell Blvd
Ste A
Davis, CA 95616
Phone (530) 747-3000

2660 W Covell Blvd
Davis, CA 95616
Phone (530) 747-3000

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

8120 Timberlake Way
Ste 201
Sacramento, CA 95823
Phone (916) 525-0620

4860 Y St
Ste 2500
Sacramento, CA 95817
Phone (916) 734-6930

77 Cadillac Dr
Ste 230
Sacramento, CA 95825
Phone (916) 920-2082

2521 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-1104

Interoperability endpoints

  • Direct secure messaging: jfeeney3460736@oc.providencedirect.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1470700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1992259709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 NE 20TH AVE STE 225",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322895",
            "telephone_number": "503-963-2801",
            "fax_number": "503-963-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N GRAHAM ST STE 550",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972272010",
            "telephone_number": "503-284-5220",
            "fax_number": "503-284-4971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEENEY",
        "first_name": "JENNIFER",
        "middle_name": "E",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-09",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "10027852",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "112965",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95010242",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "K167844",
            "state": "AK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cc_otoc_obgyn_north_front_desk_pool12223217@oc.providencedirect.org",
            "affiliation": "Y",
            "affiliationName": "The Oregon Clinic PC",
            "address_1": "501 N Graham St Ste 550",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972272010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.