Active NPI
Gerald N Backus, MA
- Counselor
- Portland, OR
National Provider Identifier
1295861979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 1500 NE Irving St
Suite 250
Portland, OR 97232-2243 - Phone
- (503) 233-4356
- NPI assigned
- Feb 26, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
1500 NE Irving St
Suite 250
Portland, OR 97232-2243
Mailing address
10441 SE Cook CT Apt 385
Milwaukie, OR 97222-1535
Phone (503) 206-7816
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
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295861979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10441 SE COOK CT APT 385",
"city": "MILWAUKIE",
"state": "OR",
"postal_code": "972221535",
"telephone_number": "503-206-7816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 NE IRVING ST",
"address_2": "SUITE 250",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972322243",
"telephone_number": "503-233-4356"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACKUS",
"first_name": "GERALD",
"middle_name": "N",
"name_prefix": "Mr.",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.