Individual provider Active NPI

Dennise Linda Trager, M.S.W., LCSW

  • Clinical Social Worker
  • Ashland, OR
National Provider Identifier
1114061348
Registry record updated Aug 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L4083 Issued in OR
Practice address
255 Mobile Dr
Ashland, OR 97520-9021
Phone
(541) 488-2264
NPI assigned
Feb 19, 2007
Last updated
Aug 6, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L4083 OR Primary

Addresses

Primary practice location

255 Mobile Dr
Ashland, OR 97520-9021

Mailing address

255 Mobile Dr
Ashland, OR 97520-9021
Phone (541) 488-2264

Other identifiers 1

IdentifierTypeStateIssuer
R160516OtherMEDICARE PTAN

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
I20090410000105 OR Practitioner - Clinical Social Worker 4789731670 Practice locations: Ashland, OR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

255 Mobile Dr
Ashland, OR 97520-9021
Phone (541) 488-2264

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003135CTMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438819200000",
    "number": "1114061348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 MOBILE DR",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975209021",
            "telephone_number": "541-488-2264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 MOBILE DR",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975209021",
            "telephone_number": "541-488-2264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAGER",
        "first_name": "DENNISE",
        "middle_name": "LINDA",
        "name_prefix": "Ms.",
        "credential": "M.S.W., LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2015-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L4083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "R160516",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, OR

Sources for this page

Verify at the official NPI Registry.