Active NPI
Ian Leupold
- Counselor
- Coos Bay, OR
National Provider Identifier
1194296178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 2020 Thompson Rd
Coos Bay, OR 97420-2041 - Phone
- (541) 267-3511
- NPI assigned
- Dec 17, 2018
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
2020 Thompson Rd
Coos Bay, OR 97420-2041
Mailing address
1750 Nebraska Ave BLDG a
Grants Pass, OR 97527-5700
Phone (541) 956-4943
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": "1545004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545004800000",
"number": "1194296178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1750 NEBRASKA AVE BLDG A",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975275700",
"telephone_number": "541-956-4943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2020 THOMPSON RD",
"city": "COOS BAY",
"state": "OR",
"postal_code": "974202041",
"telephone_number": "541-267-3511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEUPOLD",
"first_name": "IAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-12-17",
"last_updated": "2018-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coos Bay, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.