Individual provider Active NPI

Gary L Barnes, MSW, LCSW

  • Clinical Social Worker
  • Corvallis, OR
National Provider Identifier
1164635314
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L1688 Issued in OR
Practice address
760 SW Madison Ave Ste 103
Corvallis, OR 97333-4589
Phone
(541) 752-9826
Fax
(866) 905-8115
NPI assigned
May 7, 2007
Last updated
Mar 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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 L1688 OR Primary

Addresses

Primary practice location

760 SW Madison Ave Ste 103
Corvallis, OR 97333-4589

Mailing address

760 SW Madison Ave Ste 103
Corvallis, OR 97333-4589
Phone (541) 752-9826

Other identifiers 1

IdentifierTypeStateIssuer
844704002OtherORREGENCE BCBSO PROV NO

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
I20050719000499 OR Practitioner - Clinical Social Worker 5597792804 Practice locations: Corvallis, OR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

891 NW Grant Ave
Corvallis, OR 97330-4539
Phone (541) 752-9826

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L1688ORMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1164635314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 SW MADISON AVE STE 103",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973334589",
            "telephone_number": "541-752-9826",
            "fax_number": "866-905-8115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 SW MADISON AVE STE 103",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973334589",
            "telephone_number": "541-752-9826",
            "fax_number": "866-905-8115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARNES",
        "first_name": "GARY",
        "middle_name": "L",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L1688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BCBSO PROV NO",
            "identifier": "844704002",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.