Individual provider Active NPI

Joseph Mohr

  • Peer Specialist
  • Portland, OR
National Provider Identifier
1386051894
Registry record updated Feb 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
15-CRM-116 Issued in OR
Practice address
1312 SW Washington St
Portland, OR 97205-2327
Phone
(503) 535-1151
NPI assigned
Jul 16, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X 15-CRM-116 OR Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X

Addresses

Primary practice location

1312 SW Washington St
Portland, OR 97205-2327

Mailing address

PO Box 3007
Portland, OR 97208-3007
Phone (503) 535-1151

Other identifiers 1

IdentifierTypeStateIssuer
15-CRM-116OtherORACCBO

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

State licenses

LicenseStateTypeSpecialty
15-CRM-116ORMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1405468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456272000000",
    "number": "1386051894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3007",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083007",
            "telephone_number": "503-535-1151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 SW WASHINGTON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052327",
            "telephone_number": "503-535-1151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHR",
        "first_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-16",
        "last_updated": "2016-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "15-CRM-116",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACCBO",
            "identifier": "15-CRM-116",
            "state": "OR"
        }
    ],
    "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 Feb 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.