Active NPI
Kevin Brooks
- Clinical Social Worker
- McMinnville, OR
National Provider Identifier
1073641122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CADC II 00-07-58
- Practice address
- 627 NE Evans St
McMinnville, OR 97128-3923 - Phone
- (503) 434-7523
- NPI assigned
- Mar 1, 2007
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CADC II 00-07-58 | OR | Primary |
Addresses
Primary practice location
627 NE Evans St
McMinnville, OR 97128-3923
Mailing address
627 NE Evans St
McMinnville, OR 97128-3923
Phone (503) 434-7523
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073641122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "627 NE EVANS ST",
"city": "MCMINNVILLE",
"state": "OR",
"postal_code": "971283923",
"telephone_number": "503-434-7523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "627 NE EVANS ST",
"city": "MCMINNVILLE",
"state": "OR",
"postal_code": "971283923",
"telephone_number": "503-434-7523"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "KEVIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "CADC II 00-07-58",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McMinnville, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.