Individual provider Active NPI

Robert Lee Marrs, LCSW

  • Clinical Social Worker
  • Tigard, OR
National Provider Identifier
1003029364
Registry record updated Jul 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1179 Issued in OR
Practice address
12600 SW 72ND Ave
Suite 110
Tigard, OR 97223-8356
Phone
(503) 620-5455
NPI assigned
May 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1179 OR Primary

Addresses

Primary practice location

12600 SW 72ND Ave
Suite 110
Tigard, OR 97223-8356

Mailing address

7175 SW Beveland Rd
Ste 105
Tigard, OR 97223-8665
Phone (503) 620-5455

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091102000496 OR Practitioner - Clinical Social Worker 7315084878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11650 SW 67TH Ave
Suite 220
Portland, OR 97223-8590
Phone (503) 349-2970

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1179ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Robert L. Marrs, L.C.S.W., P.C. Clinical CurrentSince Jun 1, 1980 Accepting new patients

Locations

11650 SW 67th Ave
Ste 220
Portland, OR 97223
Phone (503) 349-2970

7175 SW Beveland Rd
Ste 105
Tigard, OR 97223
Phone (503) 244-0500

7175 SW Beveland Rd
Ste 200
Tigard, OR 97223
Phone (503) 395-5122

Organizations & group practices 1

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": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499904000000",
    "number": "1003029364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7175 SW BEVELAND RD",
            "address_2": "STE 105",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972238665",
            "telephone_number": "503-620-5455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12600 SW 72ND AVE",
            "address_2": "SUITE 110",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972238356",
            "telephone_number": "503-620-5455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRS",
        "first_name": "ROBERT",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2017-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "1179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

Verify at the official NPI Registry.