NPIMap

Organization Active NPI

Josephine County

  • Community/Behavioral Health Agency
  • Grants Pass, OR
National Provider Identifier
1295737336
Registry record updated Mar 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
JOSEPHINE COUNTY
Practice address
301 NW F Street
Grants Pass, OR 97526
Phone
(541) 474-5404
Fax
(541) 474-5103
NPI assigned
Jun 1, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2018

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

Authorized official

Name
James GoodwinNPI 1770085060
Title
Director, Juvenile Justice
Phone
(541) 474-5186

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X
Community/Behavioral Health Agency 251S00000X Primary
Non-Surgical Family Planning Clinic/Center 261QF0050X
Health Service Clinic/Center 261QH0100X
State or Local Public Health Clinic/Center 261QP0905X

Addresses

Primary practice location

301 NW F Street
Grants Pass, OR 97526

Mailing address

301 NW F Street
Grants Pass, OR 97526
Phone (541) 474-5186

Other identifiers 4

IdentifierTypeStateIssuer
043138MedicaidOR
500-500-168MedicaidOR
320093MedicaidOR
097519MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040204000415 OR Part B Supplier - Clinic/Group Practice 0941193957 Receives reassigned benefits from 1 practitioner
Practice locations: Grants Pass, OR
O20050902000312 OR Part B Supplier - Mass Immunization (Roster Biller Only) 0941193957 Practice locations: Grants Pass, OR

National Provider Directory

National Provider Directory
Tax ID family
Josephine County Men He3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

715 NW Dimmick St
Grants Pass, OR 97526
Phone (503) 474-5325

714 NW A St
Grants Pass, OR 97526
Phone (503) 474-5325

Interoperability endpoints

  • Direct secure messaging: candusanderson@jcph.allscriptsdirect.net
  • Direct secure messaging: davidcandelaria@jcph.allscriptsdirect.net

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521417600000",
    "number": "1295737336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 NW F STREET",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "97526",
            "telephone_number": "541-474-5186",
            "fax_number": "541-474-5181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 NW F STREET",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "97526",
            "telephone_number": "541-474-5404",
            "fax_number": "541-474-5103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPHINE COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-01",
        "last_updated": "2018-03-19",
        "status": "A",
        "authorized_official_last_name": "GOODWIN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "DIRECTOR, JUVENILE JUSTICE",
        "authorized_official_telephone_number": "541-474-5186"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QF0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Family Planning, Non-Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043138",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500-500-168",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "320093",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "097519",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.