JACK WILLIAMS JR. (NPI# 1083014633) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083014633 |
| Entity Type | Individual |
| Full Name | JACK WILLIAMS JR. |
| Practice Address |
687 Cheshire Ave Eugene OR 97402-5060 |
| Practice Telephone | 5417624409 |
| Practice Fax Number | 5413440772 |
| Mailing Telephone | 5417624409 |
| Mailing Fax Number | 5413440772 |
| Enumeration Date | 2014-09-02 |
| Last Update Date | 2020-09-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 172V00000X | Community Health Worker | Other Service Providers | ||
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275878142 | Jack Parker Williams | Physical Therapy Assistant | 5690 Weaver Rd, Conneaut, OH 44030-9798 | 2012-12-04 |
| 1629312988 | Jack Williams | Military Health Care Provider | 116 Dickman Dr, Dayton, OH 45431-1570 | 2012-11-26 |
| 1881823409 | Jack Shelton Williams Jr. | Registered Nurse | 806 Acquoni Rd, Suite 100, Cherokee, NC 28719-0666 | 2009-07-02 |
| 1356454722 | Jack Roger Williams | Dentist | 23706 Malibu Rd, Malibu, CA 90265 | 2006-08-17 |
| 1730195892 | Jack Lawrence Williams | Dentist | 5150 E Stop 11 Rd, Suite 11, Indianapolis, IN 46237-8628 | 2006-07-31 |
| 1053357145 | Jack A Williams | Chiropractor | 204 N Glenwood Avenue, Dalton, GA 30721-3011 | 2006-06-20 |
| 1477906279 | Jack Weston Williams IIi | Pharmacist | 2034 New Castle Ave, New Castle, DE 19720-7703 | 2016-07-15 |
| 1265658124 | Jack Owen Williams Jr. | Dentist | 3840 Woodruff Ave, Suite 206, Long Beach, CA 90808 | 2007-04-18 |
| 1598738189 | Jack Brook Williams | Specialist | 5454 Wisconsin Ave, Suite 1535, Chevy Chase, MD 20815-6901 | 2006-02-13 |
| Street Address |
687 CHESHIRE AVE |
| City | EUGENE |
| State | OR |
| Zip Code | 97402-5060 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376546291 | Willamette Family, Inc | Clinic/Center | 687 Cheshire Ave, Eugene, OR 97402-5060 | 2005-05-24 |
| 1184233736 | Olivia Marie Fulton | Counselor | 687 Cheshire Ave, Eugene, OR 97402-5060 | 2020-07-29 |
| 1376185793 | Vanessa Ann Patterson | Peer Specialist | 687 Cheshire Ave, Eugene, OR 97402-5060 | 2019-10-17 |
| 1225679061 | Hannah Leiken | Counselor | 687 Cheshire Ave, Eugene, OR 97402-5060 | 2019-10-02 |
| 1972152262 | Kaycie Kitzmiller | Counselor | 687 Cheshire Ave, Eugene, OR 97402-5060 | 2019-09-09 |
| 1184273823 | Mckayla Marie Knight | Counselor | 687 Cheshire Ave, Eugene, OR 97402-5060 | 2019-09-05 |
| 1164079018 | Tia Kerrigan | Counselor | 687 Cheshire Ave, Eugene, OR 97402-5060 | 2019-08-23 |
| 1689228751 | Kimberly Anne Brown | Counselor | 687 Cheshire Ave, Eugene, OR 97402 | 2019-07-27 |
| 1336700368 | Amber Lynn Matthews | Counselor | 687 Cheshire Ave, Eugene, OR 97402-5060 | 2019-06-20 |
| 1528622974 | Katherine Hagan | Counselor | 687 Cheshire Ave, Eugene, OR 97402-5060 | 2019-04-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538709704 | Jordan Charles Smith | Massage Therapist | 775 Menroe St., Eugene, OR 97402 | 2020-01-15 |
| 1104462134 | Cerridwen Laurel Martin | Massage Therapist | 775 Monroe St., Eugene, OR 97402 | 2019-11-25 |
| 1720556368 | Valerie Jeanne Charles | Massage Therapist | 989 Throne Dr., Eugene, OR 97402 | 2018-11-12 |
| 1407324189 | Laura Angulo | Massage Therapist | 1247 W 8th Ave Apt 10, Eugene, OR 97402 | 2018-11-11 |
| 1932687472 | Karl Alan Porter | Counselor | 1195 City View St Ste B, Eugene, OR 97402 | 2018-08-06 |
| 1992283170 | Fresenius Medical Care Dialysis Services - Oregon, LLC | Clinic/Center | 3747 W 11th Ave, Eugene, OR 97402 | 2018-07-31 |
| 1699251744 | Isabella Arlo Jane Silver | Counselor | 970 W 7th Ave., Eugene, OR 97402 | 2018-07-12 |
| 1447740527 | Shasta Tobi Cooke | Behavioral Analyst | 677 1/2 W 12th Ave, Eugene, OR 97402 | 2018-05-15 |
| 1497205306 | Jenna Bracco | Social Worker | 1274 W. 7th Avenue Suite 201, Eugene, OR 97402 | 2016-10-04 |
| 1871041392 | Jeremy Powers | Massage Therapist | 882 Van Buren St, Eugene, OR 97402 | 2016-09-13 |
| Find all providers in zip 97402 | ||||
| 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 |
|---|---|---|---|---|
| 1841810322 | Ariana Lee May | Peer Specialist | 1601 Olive St Apt 1008, Eugene, OR 97401-3985 | 2020-04-24 |
| 1053879361 | Carol Jeanne Hansen | Peer Specialist | 72a Centennial Loop Ste 150, Eugene, OR 97401-2447 | 2019-03-05 |
| 1558844324 | Roman Bezvikonnyi | Peer Specialist | 3086 Memory Ln, Eugene, OR 97404-1838 | 2018-09-07 |
| 1902305956 | Christine Noel Gray | Peer Specialist | 499 W. 4th Ave, Eugene, OR 97401 | 2018-02-06 |
| 1497296222 | Maria Regina Sison-valenti | Peer Specialist | 72a Centennial Loop, Suite 150, Eugene, OR 97401-2444 | 2017-03-13 |
| 1700335858 | Christina Gail Kazlas | Peer Specialist | 111 N Garfield St, Eugene, OR 97402-2619 | 2016-09-30 |
| 1316396187 | Matthew Allen Harlan | Peer Specialist | 4300 Goodpasture Loop, Apt.# 11, Eugene, OR 97401-1458 | 2016-06-12 |
| 1265888127 | Chenoa Bostick | Peer Specialist | 2525 Portland St, Eugene, OR 97405-3153 | 2016-05-10 |
| 1770980906 | Paul Revis | Peer Specialist | 2525 Portland St Apt 19, Eugene, OR 97405-3107 | 2014-12-03 |
| 1568607935 | Randy Jay Gudeika | Peer Specialist | 2145 Centennial Plaza, Laurel Hill Center, Eugene, OR 97401-2421 | 2008-12-12 |
| Find all providers in EUGENE | ||||
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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.