Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1992871495 Individual Practitioner Female Practitioner

Dr. Jacqueline Maria Fennerty , DPM

Podiatrist • Springfield, OR

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Jacqueline Fennerty, DPM is a certified Podiatrist practicing in Springfield, OR. With approximately 30 years of clinical experience since graduating from California School Of Podiatric Medicine in 1996, Dr. Fennerty delivers high-quality medical care to the local community at 1435 G ST.

Dr. Fennerty is affiliated with G Street Integrated Health and accepts Medicare assignment.

Frequently performed procedures and clinical services include removal of fingernails or toenails, trimming of fingernails or toenails, new patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1435 G St

Springfield, OR 974774113

Telephone 5417359420
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

California School Of Podiatric Medicine

Graduation Year

1996

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Podiatrist in Springfield, OR

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
30 Yrs Matches City Avg
City Avg: 30.0 Yrs
State Avg: 24.5 Yrs
Regional Practice Density
1 Specialists

Practicing in Springfield, OR (114 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
63.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Fennerty (30 Years) 30 Yrs
Springfield Specialty Average (30.0 Years) 30.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2021)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
11721 Removal of fingernails or toenails, 6 or more nails
22 11 $116.10 $43.38
11719 Trimming of fingernails or toenails
19 11 $38.84 $12.64

Medical Specialties & State Licenses

CMS Verified: 2025-01-14
Podiatrist Primary Specialty

NUCC Taxonomy Code: 213E00000X

State License OR DP00292

A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
150584 (OR)

Hospital & Practice Group Affiliations

G Street Integrated Health

1435 G St, Springfield, OR 974774113

Phone: 5417359420

Secondary Practice Locations

25121 Tripp Rd

Elmira, OR 974379612

Phone: 5415219387

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

31 Associated Practitioners
NPI 1013654698

QMHAI, CHW

Annamarie Pihs

Counselor - Mental Health

NPI 1053821496
Adina Henderson , NP

Nurse Practitioner

NPI 1063150704

Nurse Practitioner

NPI 1073030565
Crystal Bruce , QMHA-R

Counselor - Mental Health

NPI 1073251856

QMHAR

Sarah Cooper , FNP-C

Nurse Practitioner - Family

NPI 1184441438

Family Nurse Practitioner (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

15 Historical Events
📍
Updated Practice Location January 14, 2025

Registered at 1435 G ST, SPRINGFIELD, OR 974774113 (Tel: 5417359420)

📍
Updated Practice Location January 12, 2023

Registered at 25121 TRIPP RD, ELMIRA, OR 974379612 (Tel: 5415219387)

📍
Updated Business Mailing Address January 12, 2023

Registered at 25121 TRIPP RD, ELMIRA, OR 974379612 (Tel: 4152193875)

👤
Provider Name / Credentials Updated January 12, 2023

Recorded as JACQUELINE FENNERTY, DPM

NPI Profile Active November 14, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location November 14, 2017

Registered at 343 MAIN ST E, MONMOUTH, OR 973612334 (Tel: 5038383668)

📍
Updated Business Mailing Address November 14, 2017

Registered at 343 MAIN ST E, MONMOUTH, OR 973612334 (Tel: 5038383668)

👤
Provider Name / Credentials Updated November 14, 2017

Recorded as JACQUELINE KORDICH, DPM

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 14, 2017

Podiatrist (License #DP00292 in OR)

NPI Profile Active May 12, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location May 12, 2016

Registered at 586 PRINCESS AVE, EUGENE, OR 974053507 (Tel: 5416848166)

📍
Updated Business Mailing Address May 12, 2016

Registered at 586 PRINCESS AVE, EUGENE, OR 974053507 (Tel: 5416848166)

👤
Provider Name / Credentials Updated May 12, 2016

Recorded as JACQUELINE KORDICH, DPM

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 12, 2016

Podiatrist (License #DP00292 in OR)

🟢
Initial NPI Registration & Enumeration November 27, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1992871495
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 27, 2006
Last Update: January 14, 2025
Sole Proprietor: Yes

Mailing Address

25121 Tripp Rd

Elmira, OR 974379612

Phone: 4152193875

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.