NPIMap

Organization Active NPI

Deep Roots Family Medicine

  • Naturopath
  • Salem, OR
National Provider Identifier
1871013409
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
1781 Issued in OR
Legal business name
DEEP ROOTS FAMILY MEDICINE
Practice address
605 Union St NE
Salem, OR 97301-2462
Phone
(971) 207-3680
Fax
(503) 339-9585
NPI assigned
Jun 24, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
George Gonzales, NDNPI 1902115215
Title
Owner
Phone
(541) 602-7096

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X C3986 OR
Naturopath 175F00000X 1781 OR Primary
Naturopath 175F00000X 00960 OR

Addresses

Primary practice location

605 Union St NE
Salem, OR 97301-2462

Mailing address

605 Union St NE
Salem, OR 97301-2462
Phone (971) 207-3680

Other practice location 1

650 SW 3rd St
Corvallis, OR 97333-4437
Phone (971) 207-3680

Other identifiers 3

IdentifierTypeStateIssuer
1902115215OtherORNPPES
1184647398OtherORNPPES
1083864029OtherORNPPES

National Provider Directory

National Provider Directory

Locations

650 SW 3rd St
Corvallis, OR 97333
Phone (541) 207-3900

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1498262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1871013409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 UNION ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012462",
            "telephone_number": "971-207-3680",
            "fax_number": "503-339-9585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 UNION ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012462",
            "telephone_number": "971-207-3680",
            "fax_number": "503-339-9585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "650 SW 3rd St",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973334437",
            "country_code": "US",
            "telephone_number": "971-207-3680",
            "fax_number": "503-339-9585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DEEP ROOTS FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-24",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GONZALES",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-602-7096",
        "authorized_official_credential": "ND"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C3986",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "OR",
            "license": "1781",
            "primary": true
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "OR",
            "license": "00960",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1902115215",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1184647398",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1083864029",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.