Individual provider Active NPI

Adam Jones

  • Social Worker
  • Roseburg, OR
National Provider Identifier
1790209963
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
L11655 Issued in OR
Practice address
2700 NW Stewart Pkwy
Roseburg, OR 97471-1281
Phone
(541) 440-3532
NPI assigned
Jul 31, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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
Social Worker 104100000X L11655 OR Primary

Addresses

Primary practice location

2700 NW Stewart Pkwy
Roseburg, OR 97471-1281

Mailing address

PO Box 1121
Roseburg, OR 97470-0254

Other practice location 1

1200 Hilyard St Ste 230
Eugene, OR 97401-8122
Phone (458) 205-7450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250321002940 OR Practitioner - Clinical Social Worker 5395267058 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth Medical Group CurrentSince May 1, 2025 Accepting new patients
Peacehealth Medical Group Social Worker CurrentSince May 1, 2025 Accepting new patients

Locations

1200 Hilyard St
Eugene, OR 97401
Phone (458) 205-7070

4010 Aerial Way
Eugene, OR 97402
Phone (541) 242-8300

1200 Hilyard St
Ste 230
Eugene, OR 97401
Phone (458) 205-6016

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1790209963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1121",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974700254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 NW STEWART PKWY",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711281",
            "telephone_number": "541-440-3532"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Hilyard St Ste 230",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974018122",
            "country_code": "US",
            "telephone_number": "458-205-7450",
            "fax_number": "458-205-7459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "ADAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-31",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OR",
            "license": "L11655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

Verify at the official NPI Registry.