Jeff P Koeppel, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L3908 Issued in OR

Practice address

410 N 9TH St
Cottage Grove, OR 97424-1307

Phone

(541) 942-2850

Fax

(541) 942-1574

NPI assigned

Dec 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Clinical Social Worker

Education

Berkeley Northeastern State University - College of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Lane Mental Health Services, IncGroup PAC ID 0042544504, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• South Lane Mental Health Services, Inc

  • Community/Behavioral Health Agency
  • Cottage Grove, OR
  • NPI 1306905831
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1235298696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 N 9TH ST",
            "city": "COTTAGE GROVE",
            "state": "OR",
            "postal_code": "974241307",
            "telephone_number": "541-942-2850",
            "fax_number": "541-942-1574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N 9TH ST",
            "city": "COTTAGE GROVE",
            "state": "OR",
            "postal_code": "974241307",
            "telephone_number": "541-942-2850",
            "fax_number": "541-942-1574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEPPEL",
        "first_name": "JEFF",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L3908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019047",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie E Kim, MD
• Ellie Klopp, QMHP
• Diana L. V. Knee, LCSW
• Craig C Knutson
• Toni Nichole Knutson
• Holly Kolodziejczak, CSWA
• Yulia Kotlyar
• Daniel Kranitz, DO
• L Brent Bitner DDS PC
• Melissa Ladd, EPDH

• Clinical Social Worker in Cottage Grove, OR
• Providers in Cottage Grove, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.