Individual provider Active NPI

Megan Rae Weaver

  • Clinical Social Worker
  • Redmond, OR
National Provider Identifier
1376880120
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L11949 Issued in OR
Practice address
244 NW Kingwood Ave
Redmond, OR 97756-1688
Phone
(541) 322-7500
NPI assigned
Jan 14, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Addiction (Substance Use Disorder) Counselor 101YA0400X 14-03-24 OR
Clinical Social Worker 1041C0700X L11949 OR Primary
Case Manager/Care Coordinator 171M00000X 14-03-24 OR

Addresses

Primary practice location

244 NW Kingwood Ave
Redmond, OR 97756-1688

Mailing address

2577 NE Courtney Dr
Bend, OR 97701-7752
Phone (541) 322-7500

Other practice location 1

63311 Jamison St
Bend, OR 97703-8288
Phone (541) 322-7500

Other practice location 2

2577 NE Courtney Dr
Bend, OR 97701
Phone (541) 322-7500

Other practice location 3

58646 McNulty Way
Saint Helens, OR 97051-6210
Phone (503) 397-5211

Other identifiers 1

IdentifierTypeStateIssuer
195164MedicaidOR

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250102002297 OR Practitioner - Clinical Social Worker 8527595560 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deschutes County OregonGroup PAC ID 9638083371, 58 clinicians

Practice addresses (Care Compare)

2577 NE Courtney Dr
Bend, OR 97701-7638
Phone (541) 327-7400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L11949ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Deschutes County Oregon CurrentSince Dec 1, 2024 Accepting new patients
Deschutes County Oregon CurrentSince Dec 1, 2024 Accepting new patients
Deschutes County Oregon PastSince Sep 1, 2020 Accepting new patients

Locations

2577 NE Courtney Dr
Bend, OR 97701
Phone (541) 322-7400

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1358121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1376880120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2577 NE COURTNEY DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017752",
            "telephone_number": "541-322-7500",
            "fax_number": "541-322-7565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 NW KINGWOOD AVE",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561688",
            "telephone_number": "541-322-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "63311 Jamison St",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977038288",
            "country_code": "US",
            "telephone_number": "541-322-7500",
            "fax_number": "541-322-7565",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2577 NE Courtney Dr",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "97701",
            "country_code": "US",
            "telephone_number": "541-322-7500",
            "fax_number": "541-322-7565",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "58646 McNulty Way",
            "address_purpose": "LOCATION",
            "city": "Saint Helens",
            "state": "OR",
            "postal_code": "970516210",
            "country_code": "US",
            "telephone_number": "503-397-5211",
            "fax_number": "503-397-5373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "MEGAN",
        "middle_name": "RAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-14",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "14-03-24",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L11949",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OR",
            "license": "14-03-24",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195164",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, OR

Sources for this page

Verify at the official NPI Registry.