Individual provider Active NPI

G Jason Wilks, DPM

  • Podiatrist
  • Roseburg, OR
National Provider Identifier
1316006539
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
DP00318 Issued in OR
Practice address
1813 W Harvard Ave Ste 201
Roseburg, OR 97471-2754
Phone
(541) 673-0742
Fax
(541) 673-7553
NPI assigned
Dec 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X DP00318 OR Primary

Addresses

Primary practice location

1813 W Harvard Ave Ste 201
Roseburg, OR 97471-2754

Mailing address

1813 W Harvard Ave Ste 201
Roseburg, OR 97471-2754
Phone (541) 673-0742

Other identifiers 8

IdentifierTypeStateIssuer
067946000OtherORREGENCE
7600580001OtherORPTAN DME
DX4938OtherORRR MDC GROUP PTAN
500720262MedicaidOR
430895102OtherORREGENCE BC HMO
480028890OtherRR MEDICARE
R192914OtherORPTAN MEDICARE ORGANIZATION
D201111OtherORPACIFIC SOURCE

Other names 1

  • Gordon Jason Wilks Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080213000514 OR Practitioner - Podiatry 5395828321 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1813 W Harvard Ave
Suite 201
Roseburg, OR 97471-2754
Phone (541) 673-0742

Hospital & facility affiliations

  • Amedisys Home Health Care Home health agency, Roseburg, OR, CCN 387311
  • Mercy Medical Center Hospital, Roseburg, OR, CCN 380027

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue262
Removal of skin lesions1-10
Removal of nail tissue631
Removal or shaving of skin growth197
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
G Jason Wilks DPM PC Podiatrist CurrentSince Dec 17, 2016 Accepting new patients

Locations

2564 NW Edenbower Blvd
Ste 142
Roseburg, OR 97471
Phone (541) 673-0742

1813 W Harvard Ave
Ste 201
Roseburg, OR 97471
Phone (541) 440-6390

2579 NW Edenbower Blvd
Roseburg, OR 97471
Phone (541) 673-5225

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1316006539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1813 W HARVARD AVE STE 201",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974712754",
            "telephone_number": "541-673-0742",
            "fax_number": "541-673-7553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1813 W HARVARD AVE STE 201",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974712754",
            "telephone_number": "541-673-0742",
            "fax_number": "541-673-7553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKS",
        "first_name": "G",
        "middle_name": "JASON",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OR",
            "license": "DP00318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "067946000",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN DME",
            "identifier": "7600580001",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MDC GROUP PTAN",
            "identifier": "DX4938",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500720262",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BC HMO",
            "identifier": "430895102",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "480028890",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN MEDICARE ORGANIZATION",
            "identifier": "R192914",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFIC SOURCE",
            "identifier": "D201111",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GORDON",
            "last_name": "WILKS",
            "middle_name": "JASON",
            "credential": "DPM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Roseburg, OR

Sources for this page

Verify at the official NPI Registry.