Jared Utterback

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

T1907 Issued in OR

Practice address

695 SW Mill View Way Ste 207
Bend, OR 97702-1557

Phone

(458) 202-9632

NPI assigned

May 22, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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

Marriage and Family Therapist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Brightways Counseling Group LLC

  • Group Psychotherapy Psychologist
  • Redmond, OR
  • NPI 1689191165
  NPD (past)

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

{
    "created_epoch": "1558483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1265099550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61181 LODGEPOLE DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977022880",
            "telephone_number": "458-202-9632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 SW MILL VIEW WAY STE 207",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021557",
            "telephone_number": "458-202-9632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UTTERBACK",
        "first_name": "JARED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-22",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "R5529",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "T1907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500767552",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meredith Maya Uribe
• Natalia Usatii, M.D.
• Victor Usatii, M.D.
• Teresa L Uselman
• Nicole Lee Utt
• Sandra Vaala
• Maria Vacarella, C.N.M.
• Noelle Dominique Vacchio-Caulley, PA-C
• Michael Alexander Valdez, PA-C
• Anna Krista Alicia Valencia

• Marriage & Family Therapist in Bend, OR
• Providers in Bend, OR by specialty
• Marriage & Family Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; 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.