Individual provider Active NPI

Mitchell Ray Trotter, LCSW

  • Clinical Social Worker
  • Eugene, OR
National Provider Identifier
1518106087
Registry record updated Dec 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L7207 Issued in OR
Practice address
71 Centennial Loop Ste a
Eugene, OR 97401-2443
Phone
(541) 858-8170
NPI assigned
Feb 6, 2009
Last updated
Dec 31, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L7207 OR Primary

Addresses

Primary practice location

71 Centennial Loop Ste a
Eugene, OR 97401-2443

Mailing address

3587 Heathrow Way # Or97504
Medford, OR 97504-4004

Other practice location 1

3587 Heathrow Way # Or97504
Medford, OR 97504
Phone (541) 858-8170

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
I20190410002265 OR Practitioner - Clinical Social Worker 7214278720 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lane County Oregon CurrentSince Apr 1, 2019 Accepting new patients

Locations

1022 Green Acres Rd
Eugene, OR 97408
Phone (541) 682-7206

2411 Martin Luther King Jr Blvd
Eugene, OR 97401
Phone (541) 682-3608

2073 Olympic St
Springfield, OR 97477
Phone (541) 682-3530

Interoperability endpoints

  • Direct secure messaging: mitchell.trotter.p1@direct.lanecounty.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1233878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546214400000",
    "number": "1518106087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3587 HEATHROW WAY # OR97504",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 CENTENNIAL LOOP STE A",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012443",
            "telephone_number": "541-858-8170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3587 Heathrow Way # Or97504",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "97504",
            "country_code": "US",
            "telephone_number": "541-858-8170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TROTTER",
        "first_name": "MITCHELL",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-06",
        "last_updated": "2018-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L7207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.