Individual provider Active NPI

Jerome Carl Vergamini, M.D.

  • Child & Adolescent Psychiatry Physician
  • Eugene, OR
National Provider Identifier
1568404689
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
09121 Issued in OR
Practice address
1358 Oak St. #3
Eugene, OR 97401-3581
Phone
(541) 686-9991
Fax
(541) 343-9441
NPI assigned
Jun 12, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 09121 OR Primary

Addresses

Primary practice location

1358 Oak St. #3
Eugene, OR 97401-3581

Mailing address

1047 Brookside Dr
Eugene, OR 97405-4913
Phone (541) 484-0692

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
09121ORMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lane County Oregon Past Accepting new patients

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1568404689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1047 BROOKSIDE DR",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974054913",
            "telephone_number": "541-484-0692",
            "fax_number": "541-484-1605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1358 OAK ST. #3",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013581",
            "telephone_number": "541-686-9991",
            "fax_number": "541-343-9441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERGAMINI",
        "first_name": "JEROME",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "OR",
            "license": "09121",
            "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 Jul 13, 2026; 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.