JOSEPH MYRON JACOBUS (NPI# 1316447253) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316447253 |
| Entity Type | Individual |
| Full Name | JOSEPH MYRON JACOBUS |
| Credential | CRM |
| Practice Address |
900 Main St Ste 200 Oregon City OR 97045-1869 |
| Mailing Address |
Po Box 16756 Portland OR 97292-0756 |
| Practice Telephone | 9713863408 |
| Enumeration Date | 2018-02-16 |
| Last Update Date | 2018-02-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | 17-CRM-118 | OR | Other Service Providers |
| Street Address |
900 MAIN ST STE 200 |
| City | OREGON CITY |
| State | OR |
| Zip Code | 97045-1869 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043464399 | Michele Anne Bradfute | Counselor | 900 Main St Ste 200, Oregon City, OR 97045-1869 | 2008-11-13 |
| 1700484409 | Tina Berglund | Peer Specialist | 900 Main St Ste 200, Oregon City, OR 97045-1869 | 2020-10-14 |
| 1659988814 | Trista Kildow | Peer Specialist | 900 Main St Ste 200, Oregon City, OR 97045-1869 | 2020-09-30 |
| 1497387096 | Shayna Pukini | Counselor | 900 Main St Ste 200, Oregon City, OR 97045-1869 | 2020-02-11 |
| 1336708106 | Anthony Lewis | Case Manager/Care Coordinator | 900 Main St Ste 200, Oregon City, OR 97045-1869 | 2019-06-06 |
| 1386201416 | Cory Dean Tucker | Peer Specialist | 900 Main St Ste 200, Oregon City, OR 97045-1869 | 2019-05-23 |
| 1841762077 | Jeremiah Rider | Peer Specialist | 900 Main St Ste 200, Oregon City, OR 97045-1869 | 2018-12-28 |
| 1669944583 | Megan Marie Allen | Peer Specialist | 900 Main St Ste 200, Oregon City, OR 97045-1869 | 2018-12-18 |
| 1881173888 | Danny Trevitts | Counselor | 900 Main St Ste 200, Oregon City, OR 97045-1869 | 2018-08-09 |
| 1447756523 | Ron Maudsley | Counselor | 900 Main St Ste 200, Oregon City, OR 97045-1869 | 2018-04-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528625621 | Dylan Wile | Physical Therapist | 19721 Or 213, Oregon City, OR 97045 | 2019-05-23 |
| 1952871576 | April Saylor | Dental Hygienist | 15530 S. Morel Dr, Oregon City, OR 97045 | 2018-11-27 |
| 1598251688 | Sara Noelle Wetten | Dental Assistant | 1900 Mclouglin Blvd #68, Oregon City, OR 97045 | 2018-07-02 |
| 1649761941 | Carol Ann Cranfill | Specialist | 1001 Molalla Ave. Ste 206, Oregon City, OR 97045 | 2018-05-22 |
| 1790286029 | Kathleen Walker | Registered Nurse | 110 Beaverceek Rd., Oregon City, OR 97045 | 2018-02-22 |
| 1174032429 | Amanda Brannin | Dental Hygienist | 15018 Pebble Beach Dr, Oregon City, OR 97045 | 2017-09-28 |
| 1003332669 | Clackamas Medical Supplies | Durable Medical Equipment & Medical Supplies | 2050 Beavercreek Rd. Ste 101-385, Oregon, OR 97045 | 2017-08-16 |
| 1154870129 | Staci S Meador | Nurse Practitioner | 1508 Division St Ste 200, Oregon City, OR 97045 | 2016-10-01 |
| 1821541939 | Samuel R. Sabo | General Practice | 18171 Waldow Rd., Oregon City, OR 97045 | 2016-07-26 |
| 1619339967 | Carly Chambers | Physical Therapist | 1630 S Beavercreeak Rd, Suite A, Oregon City, OR 97045 | 2016-03-25 |
| Find all providers in zip 97045 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518565191 | Katie Spear | Peer Specialist | 900 Main St, Oregon City, OR 97045-1834 | 2020-10-15 |
| 1700484409 | Tina Berglund | Peer Specialist | 900 Main St Ste 200, Oregon City, OR 97045-1869 | 2020-10-14 |
| 1659988814 | Trista Kildow | Peer Specialist | 900 Main St Ste 200, Oregon City, OR 97045-1869 | 2020-09-30 |
| 1811528193 | Angelina Starr Sloan | Peer Specialist | 112 Beavercreek Rd, Oregon City, OR 97045-4302 | 2020-01-27 |
| 1386274041 | Robert Speck | Peer Specialist | 900 Main St, Oregon City, OR 97045-1834 | 2020-01-22 |
| 1386201416 | Cory Dean Tucker | Peer Specialist | 900 Main St Ste 200, Oregon City, OR 97045-1869 | 2019-05-23 |
| 1841762077 | Jeremiah Rider | Peer Specialist | 900 Main St Ste 200, Oregon City, OR 97045-1869 | 2018-12-28 |
| 1669944583 | Megan Marie Allen | Peer Specialist | 900 Main St Ste 200, Oregon City, OR 97045-1869 | 2018-12-18 |
| 1699276550 | Paul Modesitt | Peer Specialist | 900 Main St Ste 200, Oregon City, OR 97045-1869 | 2018-02-26 |
| 1255840856 | Melinda Brummett | Peer Specialist | 2051 Kaen Rd, Oregon City, OR 97045-4035 | 2017-09-26 |
| Find all providers in OREGON CITY | ||||
| City | OREGON CITY |
| Zip Code | 97045 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.