DR. JENNIFER NICOLE GREEN (NPI# 1043519895) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043519895 |
| Entity Type | Individual |
| Full Name | DR. JENNIFER NICOLE GREEN |
| Credential | D.O. |
| Practice Address |
2435 Ne Cumulus Ave., Ste A Mcminnville OR 97128-8862 |
| Practice Telephone | 5034348286 |
| Mailing Telephone | 5034348286 |
| Enumeration Date | 2011-03-18 |
| Last Update Date | 2016-06-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | DO 167350 | OR | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | MEDICAL LICENSE | DO167350 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588205249 | Jennifer Moody Green | Licensed Vocational Nurse | 16418 Brookford Dr, Houston, TX 77059-4707 | 2019-10-03 |
| 1003478801 | Jennifer C Green | Nurse Practitioner | 838 E 625 S, Layton, UT 84041-4300 | 2019-07-01 |
| 1568946978 | Jennifer Dean Green | Day Training/Habilitation Specialist | 523 2nd St E, Scott City, MO 63780-2418 | 2018-09-20 |
| 1134608458 | Jennifer Green | Occupational Therapy Assistant | 448 Pendrey Dr, Port Orange, FL 32127-9528 | 2018-08-08 |
| 1639660103 | Jennifer Green | Occupational Therapist | 4209 Mtn.terrace, Memphis, TN 38127 | 2018-05-21 |
| 1154833747 | Jennifer Green | Acupuncturist | 5000 Davis Ln Ste 106, Austin, TX 78749-3802 | 2017-11-03 |
| 1376097071 | Jennifer Green | Nurse Practitioner | 199 Douglas Dr, Hallsville, TX 75650-7321 | 2016-08-10 |
| 1982091849 | Jennifer Hannah Green | Social Worker | 11511 Douglas Ave, Apt. 206, Huntley, IL 60142-7187 | 2015-04-17 |
| 1174921357 | Jennifer Green | Contractor | 2253 Calvert St, Virginia Beach, VA 23451-1739 | 2014-12-20 |
| 1023439122 | Jennifer Michelle Green | Speech-Language Pathologist | 7055 Mexico Road Suite 1601, St. Peters, MO 63376-9998 | 2013-12-17 |
| Street Address |
2435 NE CUMULUS AVE., STE A |
| City | MCMINNVILLE |
| State | OR |
| Zip Code | 97128-8862 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518565035 | Bkd Hillside Opco, LLC | Skilled Nursing Facility | 440 Nw Hillside Park Way, Mcminnville, OR 97128 | 2020-10-16 |
| 1811502636 | Sean Peter Christian Cavaghan | Counselor | 1900 Ne Hwy 99, Suite K, Mcminnville, OR 97128 | 2020-09-09 |
| 1386269637 | Tending The Vineyard | Clinic/Center | 127 Nw Highway 99w, Mcminnville, OR 97128 | 2020-06-12 |
| 1619441094 | Kami Naber | Counselor | 672 Ne Evans St, Mcminnville, OR 97128 | 2019-01-18 |
| 1720552102 | Lauren Nicole Abshire | Counselor | 672 Ne Evans Street, Mcminnville, OR 97128 | 2019-01-18 |
| 1366933376 | Maria G Guerrero | Specialist | 325 Nw Fenton St, Mcminnville, OR 97128 | 2018-05-24 |
| 1235628819 | Julie Luedtke | Health Educator | 300 Sw Hill Road South, Mcminnville, OR 97128 | 2018-05-09 |
| 1356838817 | Jacqueline Ann Hausman | Massage Therapist | 119 Ne 3rd St., Mcminnville, OR 97128 | 2018-04-19 |
| 1366960007 | Alexis R Burke | Counselor | 625 Ne Galloway, Mcminnville, OR 97128 | 2017-09-01 |
| 1871018705 | Amanda Rose Bunch | Counselor | 418 Se Holly Way, Mcminnville, OR 97128 | 2017-08-11 |
| Find all providers in zip 97128 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942590328 | Joanna M Zamora | Pediatrics | 2435 Ne Cumulus Ave, Suite A, Mcminnville, OR 97128-8805 | 2011-04-19 |
| 1417040536 | Rogina K Reuter | Pediatrics | 611 Red Road, Mcminnville, TN 37110 | 2006-10-02 |
| 1619942331 | Stacey Leigh Winters | Pediatrics | 2700 Se Stratus Ave Unit 405, Mcminnville, OR 97128-6258 | 2006-02-17 |
| 1316949969 | Jeffrey K Mcvey | Pediatrics | 236 E Main St, Mcminnville, TN 37110-2508 | 2005-08-12 |
| 1770588337 | William J. Koenig | Pediatrics | 254 Ne Norton Lane, Mcminnville, OR 97128-4698 | 2005-06-20 |
| 1518384627 | Maryalice Mcnamara | Pediatrics | 115 Ne May Ln, Mcminnville, OR 97128-9272 | 2014-03-26 |
| 1932364049 | Amy L Rogers | Pediatrics | 236 E Main St, Mcminnville, TN 37110-2508 | 2008-07-29 |
| 1184816720 | Pioneer Pediatrics, Pllc | Pediatrics | 236 E Main St, Mcminnville, TN 37110-2508 | 2007-08-17 |
| 1336183227 | Michael G. Andrews | Pediatrics | 236 E Main St, Pioneer Pediatrics, Pllc, Mcminnville, TN 37110-2508 | 2006-06-15 |
| 1053364562 | Brent Heimuller | Pediatrics | 2435 Ne Cumulus Ave Ste A, Mcminnville, OR 97128-8862 | 2006-05-18 |
| Find all providers in MCMINNVILLE | ||||
| City | MCMINNVILLE |
| Zip Code | 97128 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.