Bradley Paul Roan Eagle

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

T-20-486 Issued in OR

Practice address

3425 13TH St
Baker City, OR 97814-1340

Phone

(605) 516-0083

NPI assigned

Dec 20, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• New Directions Northwest, Inc

  • Community/Behavioral Health Agency
  • Baker City, OR
  • NPI 1235124462
  NPD

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

{
    "created_epoch": "1576800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1497393425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 13TH ST",
            "city": "BAKER CITY",
            "state": "OR",
            "postal_code": "978141340",
            "telephone_number": "541-523-7400",
            "fax_number": "541-523-4927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 13TH ST",
            "city": "BAKER CITY",
            "state": "OR",
            "postal_code": "978141340",
            "telephone_number": "605-516-0083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROAN EAGLE",
        "first_name": "BRADLEY",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-20",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OR",
            "license": "20-QMHA-R-0842",
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "21-CRM-411",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "T-20-486",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "CADC-RT-20-486",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRM CERTIFICATE - MHACBO",
            "identifier": "21-CRM-411",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50079031",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Luisa Reyes Sierra
• Erin Danielle Richard, LCSW
• David Alan Richards, MD
• Kennan Dale Richards, DO
• Jason Riley
• Marsha Ann Roark
• Robert J Bachman P T PC
• Kelsey Joy Robinson, PHARMD
• Heidi Norine Rogers Hug, CADC I
• Rushton Podiatry PC

• Addiction (Substance Use Disorder) Counselor in Baker City, OR
• Providers in Baker City, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2025; 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.