Equinox Clinics LLC

Primary specialty

Addiction Medicine (Preventive Medicine) PhysicianTaxonomy code 2083A0300X

Legal business name

EQUINOX CLINICS LLC

Practice address

160 E 18TH Ave
Eugene, OR 97401-4160

Phone

(541) 790-2455

NPI assigned

Apr 22, 2019

Organization subpart

No

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

Authorized official

Name

Randall Douglas KellyNPI 1922393974

Title

DMSC Pac

Phone

(206) 418-8222

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 4

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

• Randall Douglas Kelly, MHS, DMSC, PA-C

  • Physician Assistant
  • Hermiston, OR
  • NPI 1922393974
  Medicare reassignment Authorized official
• Morio C McWilliams, PAC

  • Physician Assistant
  • Portland, OR
  • NPI 1316242399
  Medicare reassignment
• Martin Lee Nelms, CRM

  • Peer Specialist
  • Eugene, OR
  • NPI 1851063622
  NPD
• Jen Dygert, M.S.W., L.C.S.W.

  • Mental Health Counselor
  • Eugene, OR
  • NPI 1255477949
  NPD (past)

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

{
    "created_epoch": "1555891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706572800000",
    "number": "1659934982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 E 18TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014160",
            "telephone_number": "206-418-8222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E 18TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014160",
            "telephone_number": "541-790-2455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EQUINOX CLINICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-22",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "DMSC PAC",
        "authorized_official_telephone_number": "206-418-8222"
    },
    "taxonomies": [
        {
            "code": "2083A0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alison Epperly, M.S., CCC-SLP
• Rachel Elizabeth Epperson
• Tracey Eppler
• Richard E Epplett, DMD
• Leonard R. Epstein, PH.D.
• Erica L Hernandez LCSW, LLC
• Erica L Hernandez, LCSW, LLC
• Daniel James Erickson, DDS
• Donald Allen Erickson, MA, LPC
• Laurie Ann Erickson, T.H.W & M.A.I.S.

• Addiction Medicine (Preventive Medicine) Physician in Eugene, OR
• Providers in Eugene, OR by specialty
• Addiction Medicine (Preventive Medicine) Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.