Nick Paul Jacoby, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L6907 Issued in OR

Practice address

1002 Library CT
Oregon City, OR 97045-4066

Phone

(503) 655-8264

Fax

(503) 655-8428

NPI assigned

Aug 20, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County of Clackamas Office of County AuditorGroup PAC ID 9537065560, 75 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Clackamas County

  • Federally Qualified Health Center (FQHC)
  • Oregon City, OR
  • NPI 1841443587
  Medicare reassignment Care Compare group NPD
• County of Clackamas Office of County Auditor

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Milwaukie, OR
  • NPI 1245269315
  NPD
• Clackamas County

  • Federally Qualified Health Center (FQHC)
  • Clackamas, OR
  • NPI 1891042487
  NPD (past)

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

{
    "created_epoch": "1250726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456358400000",
    "number": "1609008853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 LIBRARY CT",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970454066",
            "telephone_number": "503-655-8264",
            "fax_number": "503-655-8428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 LIBRARY CT",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970454066",
            "telephone_number": "503-655-8264",
            "fax_number": "503-655-8428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBY",
        "first_name": "NICK",
        "middle_name": "PAUL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-20",
        "last_updated": "2016-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L6907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina M Jackson
• Christopher Shaun Jackson
• Dana Nicole Jackson
• Joseph Myron Jacobus, CRM
• Kimberly Ann Jacoby, PNP-PC
• James Resk, M.D., P.C.
• Kevin J Jamison, MD
• Spencer Jamison
• James R Janoski, QMHP
• Teri L Jarmon, CADCII

• Clinical Social Worker in Oregon City, OR
• Providers in Oregon City, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2016; 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.

Verify at the official NPI Registry.