John Lyle Pfeiffer

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

10362 SW McDonald St
Tigard, OR 97224-4863

Phone

(503) 624-0312

Fax

(503) 639-3973

NPI assigned

Sep 17, 2013

Reactivated

Mar 2, 2021

Last updated

May 27, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Coda, Inc.

  • Substance Abuse Rehabilitation Facility
  • Portland, OR
  • NPI 1437213865
  NPD
• Coda, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Seaside, OR
  • NPI 1750912184
  NPD

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

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1821424326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141328",
            "telephone_number": "503-239-8400",
            "fax_number": "503-239-8407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10362 SW MCDONALD ST",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972244863",
            "telephone_number": "503-624-0312",
            "fax_number": "503-639-3973"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "640 S. 2nd Street",
            "address_2": "Family Solutions",
            "address_purpose": "LOCATION",
            "city": "Central Point",
            "state": "OR",
            "postal_code": "97502",
            "country_code": "US",
            "telephone_number": "541-665-0359 x2",
            "fax_number": "541-665-0358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PFEIFFER",
        "first_name": "JOHN",
        "middle_name": "LYLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-17",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "deactivation_date": "2021-01-14",
        "reactivation_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Shane Pettigrew, D.C.
• Meagan Rene Pettigrove
• Karl Johan Pfalzgraff
• Mason Lorenzo Pfeifer
• Stephanie Pfeifer, RN
• Anthony Pham, M.D.
• Bao Pham, D.M.D.
• Hao Pham
• Kim Anh Pham
• Tamanh Pham, RDH

• Peer Specialist in Tigard, OR
• Providers in Tigard, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; 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.