Active NPI
Joshua Shafer, PMHNP
- Psychiatric/Mental Health Nurse Practitioner
- Eugene, OR
National Provider Identifier
1487926515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 10042402
- Practice address
- 770 E 11TH Ave
Eugene, OR 97401-3746 - Phone
- (458) 205-7001
- NPI assigned
- Feb 6, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Pain Management Registered Nurse | 163WP0000X | 201142212RN | OR | |
| Child & Adolescent Psychiatric/Mental Health Registered Nurse | 163WP0807X | 201142212RN | OR | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 10042402 | OR | Primary |
Addresses
Primary practice location
770 E 11TH Ave
Eugene, OR 97401-3746
Mailing address
3415 SE Powell Blvd
Portland, OR 97202-3371
Phone (503) 234-9591
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: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
770 E 11 Ave
Eugene, OR 97401-3746
Phone (458) 205-7100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201142212RN | OR | MD | Child & Adolescent Psychiatric/Mental Health Registered Nurse |
| 10042402 | OR | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peacehealth Medical Group | Social Worker | Current | Accepting new patients |
Locations
770 E 11th Ave
Eugene, OR 97401
Phone (458) 205-7000
4010 Aerial Way
Eugene, OR 97402
Phone (541) 242-8300
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744243200000",
"number": "1487926515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3415 SE POWELL BLVD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972023371",
"telephone_number": "503-234-9591"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "770 E 11TH AVE",
"city": "EUGENE",
"state": "OR",
"postal_code": "974013746",
"telephone_number": "458-205-7001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAFER",
"first_name": "JOSHUA",
"credential": "PMHNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-02-06",
"last_updated": "2025-04-10",
"certification_date": "2025-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "163WP0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, Pain Management",
"state": "OR",
"license": "201142212RN",
"primary": false
},
{
"code": "163WP0807X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
"state": "OR",
"license": "201142212RN",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "OR",
"license": "10042402",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.