NPIMap

Organization Active NPI

G Street Integrated Health

  • Clinic/Center
  • Springfield, OR
National Provider Identifier
1730734161
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
G STREET INTEGRATED HEALTH
Practice address
1435 G St
Springfield, OR 97477-4113
Phone
(541) 735-9420
Fax
(541) 747-9870
NPI assigned
Aug 2, 2019
Last updated
Apr 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

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

Authorized official

Name
Jennifer Ocker
Title
Executive Director
Phone
(541) 735-9420

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1435 G St
Springfield, OR 97477-4113

Mailing address

1435 G St
Springfield, OR 97477-4113
Phone (541) 514-5213

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190930000321 OR Part B Supplier - Clinic/Group Practice 6800126145 Receives reassigned benefits from 26 practitioners
Practice locations: Springfield, OR

National Provider Directory

National Provider Directory

Locations

1435 G St
Ste 200
Springfield, OR 97477

87983 Territorial Rd
Veneta, OR 97487
Phone (541) 935-2200

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1564704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681776000000",
    "number": "1730734161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 G ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974774113",
            "telephone_number": "541-514-5213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 G ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974774113",
            "telephone_number": "541-735-9420",
            "fax_number": "541-747-9870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G STREET INTEGRATED HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-02",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A",
        "authorized_official_last_name": "OCKER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "541-735-9420"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; 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.