Individual provider Active NPI

Jeremy Jon Van Tress, MSW

  • Clinical Social Worker
  • Albany, OR
National Provider Identifier
1790136976
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L10814 Issued in OR
Practice address
631 Elm St SW Ste 200&205
Albany, OR 97321-1952
Phone
(541) 812-5020
NPI assigned
Jun 28, 2016
Last updated
Aug 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X L10814 OR Primary

Addresses

Primary practice location

631 Elm St SW Ste 200&205
Albany, OR 97321-1952

Mailing address

815 NW 9TH St Ste 215
Corvallis, OR 97330-6173

Other practice location 1

1641 Kershaw Loop
Fayetteville, NC 28314-8913
Phone (808) 292-6697

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jvantress232118@samhealth.direct-ci.com

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Albany General Hospital CurrentSince Aug 18, 2024 Accepting new patients

Locations

631 Elm St SW
Ste 200205
Albany, OR 97321
Phone (541) 812-5020

815 NW 9th St
Ste 215
Corvallis, OR 97330
Phone (541) 768-1888

Interoperability endpoints

  • Direct secure messaging: jvantress232118@samhealth.direct-ci.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1790136976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 NW 9TH ST STE 215",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973306173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 ELM ST SW STE 200&205",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211952",
            "telephone_number": "541-812-5020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1641 Kershaw Loop",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283148913",
            "country_code": "US",
            "telephone_number": "808-292-6697",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN TRESS",
        "first_name": "JEREMY",
        "middle_name": "JON",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-28",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L10814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jvantress232118@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "631 Elm St SW Ste 200&205",
            "city": "Albany",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973211952",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albany, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.