Individual provider Active NPI

Corey Stephen Meyer, PSYD

  • Psychologist
  • Portland, OR
National Provider Identifier
1467944751
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3876 Issued in OR
Practice address
1015 NW 22ND Ave
Portland, OR 97210-3025
Phone
(503) 413-7151
NPI assigned
Jun 1, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Psychologist 103T00000X 3876 OR Primary

Addresses

Primary practice location

1015 NW 22ND Ave
Portland, OR 97210-3025

Mailing address

3710 SW US Veterans Hospital Rd
Portland, OR 97239-2964
Phone (503) 220-8262

Other practice location 1

3710 SW US Veterans Hospital Rd
Portland, OR 97239-2964
Phone (503) 220-8262

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
I20250611002915 OR Practitioner - Clinical Psychologist 7911417548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Good Samaritan Hospital and Medical CenterGroup PAC ID 0547179939, 190 clinicians

Practice addresses (Care Compare)

1015 NW 22ND Ave
Portland, OR 97210-3025
Phone (503) 413-7582

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3876ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Jun 2, 2025 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Jun 2, 2025 Accepting new patients

Locations

1130 NW 22nd Ave
Ste 400
Portland, OR 97210
Phone (503) 413-6555

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

1040 NW 22nd Ave
Ste 168
Portland, OR 97210
Phone (503) 413-7022

1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582

Organizations & group practices 2

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": "1527811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1467944751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3710 SW US VETERANS HOSPITAL RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972392964",
            "telephone_number": "503-220-8262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 NW 22ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103025",
            "telephone_number": "503-413-7151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3710 SW US Veterans Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972392964",
            "country_code": "US",
            "telephone_number": "503-220-8262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEYER",
        "first_name": "COREY",
        "middle_name": "STEPHEN",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-01",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "3876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.