John Eric Fordyce

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

THW000107123 Issued in OR

Practice address

2045 Silverton Rd NE Ste a
Salem, OR 97301-0100

Phone

(593) 588-5358

Fax

(503) 361-2688

NPI assigned

Nov 23, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Marion County

  • Methadone Clinic
  • Salem, OR
  • NPI 1386706919
  NPD

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

{
    "created_epoch": "1669161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1013627546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 MUNKERS ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973175841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 SILVERTON RD NE STE A",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973010100",
            "telephone_number": "593-588-5358",
            "fax_number": "503-361-2688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORDYCE",
        "first_name": "JOHN",
        "middle_name": "ERIC",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-23",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "THW000107123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jfordyce@co.marion.or.us",
            "affiliation": "N",
            "endpointDescription": "Secure Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2045 Silverton Rd NE Ste A",
            "city": "Salem",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973010100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "jfordyce@co.marion.or.us",
            "affiliation": "Y",
            "endpointDescription": "Secure Work Email",
            "affiliationName": "Marion County Health and Human Services",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2045 Silverton Rd NE Ste A",
            "city": "Salem",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973010100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Peer Specialist in Salem, OR
• Providers in Salem, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2022; 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.