Individual provider Active NPI

Nathan Edward Bryson, MSW

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1144423344
Registry record updated Jan 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6403 Issued in OR
Practice address
4842 SW Scholls Ferry Rd
Portland, OR 97225-1630
Phone
(503) 841-6401
NPI assigned
Jun 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2019

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 6403 OR Primary

Addresses

Primary practice location

4842 SW Scholls Ferry Rd
Portland, OR 97225-1630

Mailing address

4842 SW Scholls Ferry Rd
Portland, OR 97225-1630
Phone (503) 841-6401

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
I20260121000902 OR Practitioner - Clinical Social Worker 4789089491 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roots Therapy NW LLCGroup PAC ID 5395140222, 2 clinicians

Practice addresses (Care Compare)

6018 SE Stark St
Portland, OR 97215-1990
Phone (503) 208-6667

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6403ORMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Roots Therapy NW LLC Clinical CurrentSince Jul 14, 2021 Accepting new patients
Kaizen Consulting, LLC Clinical Past Accepting new patients

Locations

6030 SE 52nd Ave
Ste 204
Portland, OR 97206
Phone (971) 200-5789

6018 SE Stark St
Portland, OR 97215
Phone (503) 208-6667

Organizations & group practices 2

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": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548547200000",
    "number": "1144423344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4842 SW SCHOLLS FERRY RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972251630",
            "telephone_number": "503-841-6401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4842 SW SCHOLLS FERRY RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972251630",
            "telephone_number": "503-841-6401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYSON",
        "first_name": "NATHAN",
        "middle_name": "EDWARD",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2019-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "6403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.