Active NPI
Trevor Roberts
- Clinical Social Worker
- Crescent City, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 89718
- Practice address
- 2626 Maher Ave
Crescent City, CA 95531-9139 - Phone
- (916) 216-6065
- NPI assigned
- Sep 18, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 89718 | CA | Primary |
Addresses
Primary practice location
2626 Maher Ave
Crescent City, CA 95531-9139
Mailing address
PO Box 83
Crescent City, CA 95531-0083
Phone (916) 216-6065
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2015
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
36 SW Nye St
Newport, OR 97365-3821
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Lincoln | Current | Accepting new patients |
Locations
4422 NE Devils Lake Blvd
Ste 2
Lincoln City, OR 97367
Phone (541) 265-4196
51 SW Lee St
Newport, OR 97365
Phone (541) 265-0445
36 SW Nye St
Newport, OR 97365
Phone (541) 265-0445
525 N Bay St
Waldport, OR 97394
Phone (541) 265-4947
Organizations & group practices 1
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.
-
- Federally Qualified Health Center (FQHC)
- Newport, OR
- NPI 1992755664
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732838400000",
"number": "1235531567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 83",
"city": "CRESCENT CITY",
"state": "CA",
"postal_code": "955310083",
"telephone_number": "916-216-6065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2626 MAHER AVE",
"city": "CRESCENT CITY",
"state": "CA",
"postal_code": "955319139",
"telephone_number": "916-216-6065"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "TREVOR",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-09-18",
"last_updated": "2024-11-29",
"certification_date": "2024-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "89718",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crescent City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2024; 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.