Individual provider Active NPI

James Davidson Stalker, M.S.W

  • Mental Health Counselor
  • Bend, OR
National Provider Identifier
1063787976
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2542 NE Courtney Dr
Bend, OR 97701-7685
Phone
(541) 706-5935
NPI assigned
Mar 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

2542 NE Courtney Dr
Bend, OR 97701-7685

Mailing address

2577 NE Courtney Dr
Bend, OR 97701-7638
Phone (541) 322-7490

Other practice location 1

2577 NE Courtney Dr
Bend, OR 97701-7638
Phone (541) 322-7490

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jstalker18157@secure.stcharleshealthcare.org

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
I20161025002783 OR Practitioner - Clinical Social Worker 0042598005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Charles Health System IncGroup PAC ID 3870402852, 174 clinicians

Practice addresses (Care Compare)

1253 NW Canal Blvd
Redmond, OR 97756-1334
Phone (541) 548-8131

61250 SE Coombs PL
Bend, OR 97702-3704
Phone (541) 706-5935

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
St. Charles Health System, Inc. CurrentSince Sep 11, 2016 Accepting new patients
St. Charles Health System, Inc. Current Accepting new patients
St. Charles Health System, Inc. CurrentSince Sep 11, 2016 Accepting new patients

Locations

29358 Network Pl
Chicago, IL 60673

2542 NE Courtney Dr
Bend, OR 97701
Phone (541) 322-2768

61250 SE Coombs Pl
Bend, OR 97702
Phone (541) 706-5930

1253 NW Canal Blvd
Redmond, OR 97756
Phone (541) 548-8131

Organizations & group practices 11

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": "1331510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1063787976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2577 NE COURTNEY DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017638",
            "telephone_number": "541-322-7490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2542 NE COURTNEY DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017685",
            "telephone_number": "541-706-5935"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2577 NE Courtney Dr",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977017638",
            "country_code": "US",
            "telephone_number": "541-322-7490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STALKER",
        "first_name": "JAMES",
        "middle_name": "DAVIDSON",
        "credential": "M.S.W",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-12",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jstalker18157@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "2542 NE Courtney Dr",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977017685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.