NPIMap

Organization Active NPI

JD Health and Wellness Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Salem, OR
National Provider Identifier
1013363910
Registry record updated May 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
JD HEALTH AND WELLNESS CENTER
Practice address
608 Lancaster Dr SE
Salem, OR 97317-5643
Phone
(503) 877-1995
NPI assigned
May 10, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2016

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

Authorized official

Name
Mr. Eric Davis, MSW, MAC, CADCIII
Title
Clinical Administrator
Phone
(503) 877-1995

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

608 Lancaster Dr SE
Salem, OR 97317-5643

Mailing address

608 Lancaster Dr SE
Salem, OR 97317-5643
Phone (503) 877-1995

National Provider Directory

National Provider Directory
Tax ID family
JD Health and Wellness Ctr3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1462838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462838400000",
    "number": "1013363910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 LANCASTER DR SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973175643",
            "telephone_number": "503-877-1995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 LANCASTER DR SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973175643",
            "telephone_number": "503-877-1995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JD HEALTH AND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-10",
        "last_updated": "2016-05-10",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "CLINICAL ADMINISTRATOR",
        "authorized_official_telephone_number": "503-877-1995",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW, MAC, CADCIII"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.