Organization Active NPI

Compass Medical Clinic LLC

  • Family Medicine Physician
  • Dallas, OR
National Provider Identifier
1619707056
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COMPASS MEDICAL CLINIC LLC
Practice address
607 SE Jefferson St
Dallas, OR 97338-2025
Phone
(503) 623-1200
Fax
(503) 623-1414
NPI assigned
Aug 1, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Authorized official

Name
Mr. Aaron Evers, FNPNPI 1689696510
Title
Owner
Phone
(503) 623-1200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

607 SE Jefferson St
Dallas, OR 97338-2025

Mailing address

607 SE Jefferson St
Dallas, OR 97338-2025
Phone (503) 623-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241211001113 OR Part B Supplier - Clinic/Group Practice 8820524085 Receives reassigned benefits from 4 practitioners
Practice locations: Dallas, OR

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D1075230Compass Medical Clinic LLC607 SE Jefferson St, Dallas, OR 97338Certificate of waiverOct 15, 2027

National Provider Directory

National Provider Directory

Locations

607 SE Jefferson St
Dallas, OR 97338
Phone (503) 399-7520

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1722470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722470400000",
    "number": "1619707056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 SE JEFFERSON ST",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "973382025",
            "telephone_number": "503-623-1200",
            "fax_number": "503-623-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 SE JEFFERSON ST",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "973382025",
            "telephone_number": "503-623-1200",
            "fax_number": "503-623-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPASS MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-01",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A",
        "authorized_official_last_name": "EVERS",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-623-1200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.