Active NPI
Manuel Mejia Gonzalez, CHW
- Community Health Worker
- Eugene, OR
National Provider Identifier
1003664129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- THW000110435
- Practice address
- 151 W 7TH Ave RM 560
Eugene, OR 97401-1100 - Phone
- (541) 852-3891
- NPI assigned
- May 13, 2024
- Last updated
- May 13, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | THW000110435 | OR | Primary |
Addresses
Primary practice location
151 W 7TH Ave RM 560
Eugene, OR 97401-1100
Mailing address
151 W 7TH Ave RM 560
Eugene, OR 97401-1100
Phone (541) 852-3891
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| THW000110435 | OR | MD | Community Health Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lane County Oregon | Current | Accepting new patients |
Locations
151 W 7th Ave
Ste 560
Eugene, OR 97401
Phone (458) 217-4412
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715558400000",
"number": "1003664129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "151 W 7TH AVE RM 560",
"city": "EUGENE",
"state": "OR",
"postal_code": "974011100",
"telephone_number": "541-852-3891"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 W 7TH AVE RM 560",
"city": "EUGENE",
"state": "OR",
"postal_code": "974011100",
"telephone_number": "541-852-3891"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEJIA GONZALEZ",
"first_name": "MANUEL",
"credential": "CHW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-13",
"last_updated": "2024-05-13",
"certification_date": "2024-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "OR",
"license": "THW000110435",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.