Ivan Gutierrez

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1245 Edgewater St NW
Salem, OR 97304-4049

Phone

(503) 588-5816

Fax

(503) 588-5803

NPI assigned

Jan 29, 2015

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

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

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Willamette Family Medical Center IncGroup PAC ID 0749272201, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ivan.gutierrez.p1@direct.wfamilymed.nextgenshare.com

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.

• Willamette Family Medical Center Inc

  • Family Medicine Physician
  • Salem, OR
  • NPI 1649386418
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1422489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422489600000",
    "number": "1265822167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 EDGEWATER ST NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973044049",
            "telephone_number": "503-588-5816",
            "fax_number": "503-588-5803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 EDGEWATER ST NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973044049",
            "telephone_number": "503-588-5816",
            "fax_number": "503-588-5803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "IVAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-29",
        "last_updated": "2015-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Guthrie
• Sara Guthrie, LPC, MA
• Virgil A Guthrie, PHARMD
• Marlen Gutierrez Vargas
• Ana Gutierrez, MA
• Lydia Miera Gutierrez, QHMP
• Melissa Gutierrez, MA, LPCA
• Patricia Gutierrez
• Shawn Gutierrez, MA
• Guy a. Amico Jr. DMD, Inc

• Mental Health Counselor in Salem, OR
• Providers in Salem, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2015; 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.