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JERRY KEITH LPC
NPI 1528761996
Counselor - Professional in Gladstone, OR

Active since March 24, 2023PECOS EnrolledAccepts Medicare Assignment
870 82ND DR BLDG C, GLADSTONE, OR 97027(503) 659-5515 Get Directions Write a Review

NPPES record last updated: November 8, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 8, 2025, Apr 17, 2024, Mar 24, 2023 (3 updates tracked since 2023).

About Jerry Keith Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JERRY KEITH LPC (NPI 1528761996) is an individual professional provider in Gladstone, Oregon, licensed in Oregon (C10718) and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1528761996
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameJERRY KEITHCredential: LPC
Location Address870 82ND DR BLDG CGladstone, OR 97027-1803
Mailing Address870 82nd Dr Bldg CGladstone, OR 97027-1803 · (541) 399-2729
Phone(503) 659-5515
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateMarch 24, 2023
Last NPPES UpdateNovember 8, 20253 updates tracked since enumeration
NPPES CertifiedNovember 8, 2025
✔ NPI 1528761996 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in OR · C10718
870 82ND DR BLDG C, Gladstone, OR 97027
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jerry Keith Lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1658858394
PECOS Enrollment IDI20260123001030
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ERIC JAMES OVERBY CADC-R
Counselor (Addiction (Substance Use Disorder))
870 82ND DR BLDG C
GLADSTONE, OR 97027
Clackamas County (971) 396-5321
KELLIE J ROBERTS
Counselor (Addiction (Substance Use Disorder))
870 82ND DR BLDG C
GLADSTONE, OR 97027
Clackamas County (503) 659-5515
MR. STEPHEN PARISI BS
Counselor (Addiction (Substance Use Disorder))
870 82ND DR BLDG C, WESTERN PSYCHOLOGICAL & COUNSELING SERVICES
GLADSTONE, OR 97027
Clackamas County (503) 233-5404

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jerry Keith's NPI number?

The NPI number for Jerry Keith is 1528761996. It was assigned to this individual provider in the NPPES registry on March 24, 2023.

Where is Jerry Keith located?

Jerry Keith practices at 870 82nd Dr Bldg C, Gladstone, OR 97027. The listed phone number is (503) 659-5515.

What is Jerry Keith's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Jerry Keith enrolled in Medicare?

Yes. Jerry Keith is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Jerry Keith was last updated on November 8, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.