Jasper Damien Williams, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L12739 Issued in OR

Practice address

3509 NW Samaritan Dr Ste 215
Corvallis, OR 97330-3893

Phone

(541) 768-5235

NPI assigned

Feb 28, 2018

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

Electronic endpoints 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

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Salem Clinic PCGroup PAC ID 7517954514, 96 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwilliams345171@direct.salemhealth.org

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.

• Salem Clinic, PC

  • General Practice Physician
  • Salem, OR
  • NPI 1912935594
  Medicare reassignment Care Compare group
• Marion County

  • Adult Mental Health Clinic/Center
  • Salem, OR
  • NPI 1528147782
  Medicare reassignment NPD
• Deep Currents Trauma Therapy

  • Clinical Social Worker
  • Salem, OR
  • NPI 1033099098
  NPD Authorized official
• Marion County

  • Methadone Clinic
  • Salem, OR
  • NPI 1386706919
  NPD
• Salem Clinic, PC

  • General Practice Physician
  • Keizer, OR
  • NPI 1992973622
  NPD (past)
• Consumer Care LLC

  • Community/Behavioral Health Agency
  • Pocatello, ID
  • NPI 1619090628
  NPD (past)

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

{
    "created_epoch": "1519776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1295237899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3509 NW SAMARITAN DR STE 215",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303893",
            "telephone_number": "541-768-5235"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1133 N Main St",
            "address_purpose": "LOCATION",
            "city": "Pocatello",
            "state": "ID",
            "postal_code": "832042717",
            "country_code": "US",
            "telephone_number": "208-234-9361",
            "fax_number": "208-236-1855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JASPER",
        "middle_name": "DAMIEN",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-28",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LMSW-37446",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L12739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwilliams229894@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "3509 NW Samaritan Dr Ste 215",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973303893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Chelsea Lorraine Williams
• Donovan Curtis Williams, PA-C
• Erin A Williams, RN
• Jacob Williams
• Jacob Randall Williams, B.S.
• Kelsey Pearl Williams, PA
• Parker Williams
• Robert Williams
• Seth M Williams, M.D.
• Shanon Williams, DPT

• Clinical Social Worker in Corvallis, OR
• Providers in Corvallis, 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 Nov 17, 2021; 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.