Active NPI
Jade D Keglovitz, QMHA
- Mental Health Counselor
- Medford, OR
National Provider Identifier
1043947641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 2838 W Main St
Medford, OR 97501-2405 - Phone
- (541) 535-6239
- NPI assigned
- Aug 3, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
2838 W Main St
Medford, OR 97501-2405
Mailing address
931 Chevy Way
Medford, OR 97504-4127
Phone (541) 535-6239
Other practice location 1
610 S Peach St
Medford, OR 97501-3310
Phone (541) 535-6239
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788480000000",
"number": "1043947641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "931 CHEVY WAY",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975044127",
"telephone_number": "541-535-6239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2838 W MAIN ST",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975012405",
"telephone_number": "541-535-6239"
}
],
"practiceLocations": [
{
"address_1": "610 S Peach St",
"address_purpose": "LOCATION",
"city": "Medford",
"state": "OR",
"postal_code": "975013310",
"country_code": "US",
"telephone_number": "541-535-6239",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KEGLOVITZ",
"first_name": "JADE",
"middle_name": "D",
"name_prefix": "Mr.",
"credential": "QMHA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-08-03",
"last_updated": "2026-09-04",
"certification_date": "2026-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.