NPIMap

Organization Active NPI

Deschutes County Oregon

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bend, OR
National Provider Identifier
1235172180
Registry record updated Oct 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
DESCHUTES COUNTY OREGON
Practice address
2577 NE Courtney Dr
Bend, OR 97701-7638
Phone
(541) 322-7500
Fax
(541) 322-7565
NPI assigned
Jun 14, 2006
Last updated
Oct 13, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2017

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

Authorized official

Name
David Gerard Inbody
Title
Health Services Deputy Director
Phone
(541) 322-7678

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary
Adult Mental Health Clinic/Center 261QM0850X NU
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

2577 NE Courtney Dr
Bend, OR 97701-7638

Mailing address

2577 NE Courtney Dr
Bend, OR 97701-7638
Phone (541) 322-7500

Other identifiers 6

IdentifierTypeStateIssuer
047621MedicaidOR
500602527MedicaidOR
184176MedicaidOR
145789MedicaidOR
500500013MedicaidOR
170912MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031117000568 OR Part B Supplier - Clinic/Group Practice 9638083371 Receives reassigned benefits from 118 practitioners
2 other NPIs on this enrollment
Practice locations: Bend, OR; Redmond, OR; Lapine, OR

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Deschutes Co Mental Hea12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

222 SE Urania Ln
Ste 1
Bend, OR 97702

Practitioners & affiliated clinicians

Practitioners 124

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 124

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507852800000",
    "number": "1235172180",
    "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": "541-322-7500",
            "fax_number": "541-322-7565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2577 NE COURTNEY DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017638",
            "telephone_number": "541-322-7500",
            "fax_number": "541-322-7565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESCHUTES COUNTY OREGON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2017-10-13",
        "status": "A",
        "authorized_official_last_name": "INBODY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "GERARD",
        "authorized_official_title_or_position": "HEALTH SERVICES DEPUTY DIRECTOR",
        "authorized_official_telephone_number": "541-322-7678"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047621",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500602527",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "184176",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145789",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500500013",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170912",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.