Individual provider Active NPI

Kimberly Eikenberry

  • Mental Health Counselor
  • Medford, OR
National Provider Identifier
1306240254
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C6835 Issued in OR
Practice address
33 N Central Ave Ste 426
Medford, OR 97501-5940
Phone
(541) 499-4739
NPI assigned
Oct 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C6835 OR Primary

Addresses

Primary practice location

33 N Central Ave Ste 426
Medford, OR 97501-5940

Mailing address

33 N Central Ave Ste 426
Medford, OR 97501-5940
Phone (541) 499-4739

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240212004293 OR Practitioner - Mental Health Counselor 6204279706 Practice locations: Medford, OR

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

33 N Central Ave
Suite 426
Medford, OR 97501-5940
Phone (541) 499-4739

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1413849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1306240254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 N CENTRAL AVE STE 426",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975015940",
            "telephone_number": "541-499-4739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 N CENTRAL AVE STE 426",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975015940",
            "telephone_number": "541-499-4739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIKENBERRY",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-21",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C6835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.