Kindi Elaine Brumbaugh, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

1217 NE Burnside Rd
Building B, Suite 401
Gresham, OR 97030-6722

Phone

(503) 666-8832

Fax

(503) 669-8641

NPI assigned

Dec 3, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Clinical Social Worker

Education

Other, 2003

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Roseburg Therapy LLC

  • Mental Health Counselor
  • Roseburg, OR
  • NPI 1538665013
  Medicare reassignment
• Western Psychological and Counseling Services LLC

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1629345731
  NPD (past)

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

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196640000000",
    "number": "1356523112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 NE BURNSIDE RD",
            "address_2": "BUILDING B, SUITE 401",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970306722",
            "telephone_number": "503-666-8832",
            "fax_number": "503-669-8641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 NE BURNSIDE RD",
            "address_2": "BUILDING B, SUITE 401",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970306722",
            "telephone_number": "503-666-8832",
            "fax_number": "503-669-8641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUMBAUGH",
        "first_name": "KINDI",
        "middle_name": "ELAINE",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-03",
        "last_updated": "2007-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164936",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Ann Brown, RN
• Julie Rae Brown, OTA/L
• Laura Marie F Brown, MD
• Matthew Brown, ND
• Erica Bruce, PT, DPT
• Jessica Brunelle, LPC
• Cathy J Brunton, CHN
• Melody Rose Bryden
• Ava Buchanan
• Timothy Buckley, BA

• Clinical Social Worker in Gresham, OR
• Providers in Gresham, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.