NPIMap

Organization Active NPI

Coda, Inc.

  • Substance Abuse Rehabilitation Facility
  • Portland, OR
National Provider Identifier
1437213865
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
NONE ASSIGNED Issued in OR
Legal business name
CODA, INC.
Practice address
1027 E Burnside St
Portland, OR 97214-1328
Phone
(503) 239-8400
Fax
(503) 239-8407
NPI assigned
Dec 20, 2006
Last updated
Jun 21, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Mr. Timothy T. HartnettNPI 1033812441
Title
Executive Director
Phone
(503) 239-8400

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 10

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NONE ASSIGNED OR
Adult Mental Health Clinic/Center 261QM0850X NONE ASSIGNED OR
Methadone Clinic 261QM2800X NONE ASSIGNED OR
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NONE ASSIGNED OR
Mental Illness Community Based Residential Treatment Facility 320800000X NONE ASSIGNED OR
Substance Abuse Rehabilitation Facility 324500000X NONE ASSIGNED OR Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X NONE ASSIGNED OR
Mental Health Counselor 101YM0800X NONE ASSIGNED OR
Clinical Social Worker 1041C0700X
Case Manager/Care Coordinator 171M00000X NONE ASSIGNED OR

Addresses

Primary practice location

1027 E Burnside St
Portland, OR 97214-1328

Mailing address

1027 E Burnside St
Portland, OR 97214-1328
Phone (503) 239-8400

Other identifiers 2

IdentifierTypeStateIssuer
028144MedicaidOR
154948MedicaidOR

Other names 1

  • Comprehensive Options for Drug Abusers, Inc. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR2 enrollments
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20111018000517 OR Part B Supplier - Clinic/Group Practice 4082886908 Receives reassigned benefits from 4 practitioners
Practice locations: Portland, OR
O20200325002107 OR Part B Supplier - Opioid Treatment Program (Otp) 4082886908 1 other NPI on this enrollment
Practice locations: Portland, OR; Seaside, OR

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D1010842Coda, Inc1027 E Burnside, Portland, OR 97214Certificate of waiverMar 24, 2027

National Provider Directory

National Provider Directory
Tax ID family
Coda Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

  • Coda, Inc.
    • Substance Use Disorder Rehabilitation Clinic/Center
    • Seaside, OR
    • NPI 1750912184
    NPD tax ID

Locations

1027 E Burnside St
Portland, OR 97214

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 400

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 400

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1437213865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141328",
            "telephone_number": "503-239-8400",
            "fax_number": "503-239-8407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141328",
            "telephone_number": "503-239-8400",
            "fax_number": "503-239-8407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CODA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "HARTNETT",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "503-239-8400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "OR",
            "license": "NONE ASSIGNED",
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "OR",
            "license": "NONE ASSIGNED",
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "OR",
            "license": "NONE ASSIGNED",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "OR",
            "license": "NONE ASSIGNED",
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "OR",
            "license": "NONE ASSIGNED",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "OR",
            "license": "NONE ASSIGNED",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "NONE ASSIGNED",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "NONE ASSIGNED",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OR",
            "license": "NONE ASSIGNED",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "028144",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154948",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Comprehensive Options for Drug Abusers, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.