Active NPI
Stephen Jack Eccles
- Behavior Technician
- Corvallis, OR
National Provider Identifier
1740847177
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- Trillium Children'S Farm Home
4455 NE Hwy 20
Corvallis, OR 97330 - Phone
- (541) 757-1852
- NPI assigned
- May 21, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
Trillium Children'S Farm Home
4455 NE Hwy 20
Corvallis, OR 97330
Mailing address
Trillium Children'S Farm Home
4455 NE Hwy 20
Corvallis, OR 97330
Phone (541) 757-1852
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558396800000",
"number": "1740847177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "TRILLIUM CHILDREN'S FARM HOME",
"address_2": "4455 NE HWY 20",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "97330",
"telephone_number": "541-757-1852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "TRILLIUM CHILDREN'S FARM HOME",
"address_2": "4455 NE HWY 20",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "97330",
"telephone_number": "541-757-1852"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ECCLES",
"first_name": "STEPHEN",
"middle_name": "JACK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-21",
"last_updated": "2019-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corvallis, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.