Individual provider Active NPI

Ian S Nevans

  • Social Worker
  • Portland, OR
National Provider Identifier
1235643800
Registry record updated Nov 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
707 NE Couch St
Portland, OR 97232-2922
Phone
(503) 233-6090
NPI assigned
Nov 18, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

707 NE Couch St
Portland, OR 97232-2922

Mailing address

5544 NE 55TH Ave
Portland, OR 97218-2428
Phone (607) 425-6984

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1510963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510963200000",
    "number": "1235643800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5544 NE 55TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972182428",
            "telephone_number": "607-425-6984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 NE COUCH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322922",
            "telephone_number": "503-233-6090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEVANS",
        "first_name": "IAN",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-18",
        "last_updated": "2017-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.