Individual provider Active NPI

Misty Rose Bates

  • Mental Health Counselor
  • Eugene, OR
National Provider Identifier
1811278062
Registry record updated Aug 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2145 Centennial PLZ
Eugene, OR 97401
Phone
(541) 485-6340
Fax
(541) 984-3124
NPI assigned
Sep 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

2145 Centennial PLZ
Eugene, OR 97401

Mailing address

2145 Centennial PLZ
Eugene, OR 97401-2474
Phone (541) 485-6340

Other practice location 1

58646 McNulty Way
Saint Helens, OR 97051-6210
Phone (503) 397-5211

Other identifiers 1

IdentifierTypeStateIssuer
123190MedicaidOR

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": "1314835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1811278062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2145 CENTENNIAL PLZ",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012474",
            "telephone_number": "541-485-6340",
            "fax_number": "541-984-3124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2145 CENTENNIAL PLZ",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "97401",
            "telephone_number": "541-485-6340",
            "fax_number": "541-984-3124"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "58646 McNulty Way",
            "address_purpose": "LOCATION",
            "city": "Saint Helens",
            "state": "OR",
            "postal_code": "970516210",
            "country_code": "US",
            "telephone_number": "503-397-5211",
            "fax_number": "503-397-5373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BATES",
        "first_name": "MISTY",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-01",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123190",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.

Verify at the official NPI Registry.