Jacob Lane Merritt, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

412 SW Hwy 101
Lincoln City, OR 97367-2772

Phone

(541) 557-1892

NPI assigned

Sep 23, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coastal Center for Collaborative HealthGroup PAC ID 7810335767, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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 and National Provider Directory roles.

• Coastal Center for Collaborative Health

  • Community/Behavioral Health Agency
  • Corvallis, OR
  • NPI 1902259823
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1600819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1831705920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3910 AMBERWOOD DR",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750014426",
            "telephone_number": "214-418-4510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 SW HWY 101",
            "city": "LINCOLN CITY",
            "state": "OR",
            "postal_code": "973672772",
            "telephone_number": "541-557-1892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRITT",
        "first_name": "JACOB",
        "middle_name": "LANE",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-23",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robin Mays, RPH
• Brenda McAllister, RN
• Christine Lynn McCambridge, PMHNP-BC
• Jeffrey H McDonald, MD
• Kenneth Randall McEvers, DC
• Marty Michelson, LPC
• Dean W Mickelson, RPH
• John G Mickelson, DO
• Nicholas Miller, DPT
• Charito Apolonio Mina, P.T.

• Mental Health Counselor in Lincoln City, OR
• Providers in Lincoln City, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.