DR. THEODORE JENNERMANN (NPI# 1073891735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073891735 |
| Entity Type | Individual |
| Full Name | DR. THEODORE JENNERMANN |
| Other Name | DR. TED JENNERMANN |
| Credential | MD |
| Practice Address |
1460 Ne Medical Center Dr Bend OR 97701-6061 |
| Practice Telephone | 5413826633 |
| Mailing Telephone | 5413826633 |
| Mailing Fax Number | 5413822719 |
| Enumeration Date | 2011-07-29 |
| Last Update Date | 2020-10-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
MD197977 | OR | Allopathic & Osteopathic Physicians |
| Street Address |
1460 NE MEDICAL CENTER DR |
| City | BEND |
| State | OR |
| Zip Code | 97701-6061 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114900438 | Traci Lynn Clautice-engle | Radiology | 1460 Ne Medical Center Dr, Bend, OR 97701-6061 | 2005-11-21 |
| 1306265293 | Eric Choffel | Physician Assistant | 1460 Ne Medical Center Dr, Bend, OR 97701-6061 | 2014-04-08 |
| 1508201336 | Jozef M. Brozyna | Radiology | 1460 Ne Medical Center Dr, Bend, OR 97701-6061 | 2013-05-07 |
| 1013276070 | Casey George Curran | Radiology | 1460 Ne Medical Center Dr, Bend, OR 97701-6061 | 2012-05-11 |
| 1316205149 | Michael Sean Mclaughlin | Radiology | 1460 Ne Medical Center Dr, Bend, OR 97701-6061 | 2012-04-30 |
| 1134410392 | Marco Antonio Ugas | Radiology | 1460 Ne Medical Center Dr, Bend, OR 97701-6061 | 2011-04-22 |
| 1952691800 | Christopher Martin Coleman | Radiology | 1460 Ne Medical Center Dr, Bend, OR 97701-6061 | 2011-04-12 |
| 1114243490 | Nicholas Cody Bjorn Branting | Radiology | 1460 Ne Medical Center Dr, Bend, OR 97701-6061 | 2010-04-13 |
| 1548585086 | Kai Kinder | Radiology | 1460 Ne Medical Center Dr, Bend, OR 97701-6061 | 2010-03-27 |
| 1689818619 | Matthew Ross Bentz | Radiology | 1460 Ne Medical Center Dr, Bend, OR 97701-6061 | 2009-04-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104465525 | Andrew Kyle Burzynski | Denturist | 853 Ne 4th St., Bend, OR 97701 | 2020-01-02 |
| 1013480714 | Andrew Traut | Specialist/Technologist | Oregon State Force Lab, 2200 Ne Neff Rd Suite 202, Bend, OR 97701 | 2019-01-04 |
| 1871063917 | Calley Asbill, Nd LLC | Chiropractor | 2146 Ne 4th Street, Suite 160, Bend, OR 97701 | 2018-12-02 |
| 1902372212 | Carisa S Battin | Counselor | 361 Ne Franklin Avenue Bldg E #4, Bend, OR 97701 | 2018-10-15 |
| 1366921223 | Hillside Eye Center LLC | Ophthalmology | 625 Nw Colorado Avenue, Bend, OR 97701 | 2018-08-11 |
| 1528545514 | Kellie Michiko Kawasaki-jones | Dentist | 62968 Ob Riley Road, Suite 12, Bend, OR 97701 | 2018-07-23 |
| 1992255327 | Shelby Chiropractic | Chiropractor | 561 Ne Bellevue Dr Ste 102, Bend, OR 97701 | 2016-10-10 |
| 1144671520 | Kevin Richard Pett | Acupuncturist | 39 Nw Louisanna Ave., Hawthorn Healing Arts Center, Bend, OR 97701 | 2016-06-27 |
| 1912357500 | Sheldon Shawn Doveri | Driver | 233 Nw Revere Ave, Bend, OR 97701 | 2016-06-15 |
| 1740647411 | Anne Power | Homeopath | 2100 Ne Neff Rd Suite B, Bend, OR 97701 | 2016-01-26 |
| Find all providers in zip 97701 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| 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 Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932621588 | Cascade Medical Imaging LLC | Radiology | 61270 Se Coombs Pl Ste 100, Bend, OR 97702-3704 | 2017-07-14 |
| 1003338963 | Central Oregon Magnetic Resonance Imaging LLC | Radiology | 61270 Se Coombs Pl Ste 150, Bend, OR 97702-3704 | 2017-07-12 |
| 1740713908 | Radiology Associates, PC | Radiology | 60472 Snap Shot Loop, Bend, OR 97702-2539 | 2017-04-05 |
| 1023164613 | Brant David Wommack | Radiology | 1460 Ne Medical Ctr Dr, Bend, OR 97701-6061 | 2007-01-26 |
| 1114084019 | Zeke Hendricks | Radiology | 60625 Teton Ct, Bend, OR 97702-9324 | 2007-01-02 |
| 1124031042 | David R Zulauf | Radiology | 1460 Ne Medical Center Drive, Bend, OR 97701 | 2006-08-14 |
| 1114900438 | Traci Lynn Clautice-engle | Radiology | 1460 Ne Medical Center Dr, Bend, OR 97701-6061 | 2005-11-21 |
| 1659970168 | Central Oregon Radiology Assoc., P.C. | Radiology | 1475 Sw Chandler Ave Ste 202, Bend, OR 97702-3240 | 2020-10-26 |
| 1043846538 | Richard Rotondi | Radiology | 2052 Ne 4th St, Bend, OR 97701-3825 | 2020-03-17 |
| 1659813392 | Medford Radiological Group PC | Radiology | 1501 Ne Medical Center Dr, Bend, OR 97701-6051 | 2016-11-11 |
| Find all providers in BEND | ||||
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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.