Grant Judson Gill

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1817 16TH St
North Bend, OR 97459-2629

Phone

(541) 297-6230

NPI assigned

Jul 27, 2020

Last updated

Jul 27, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1595808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1427667328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 LACLAIR ST",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202988",
            "telephone_number": "541-266-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 16TH ST",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974592629",
            "telephone_number": "541-297-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "GRANT",
        "middle_name": "JUDSON",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-27",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gillgr@oregonstate.edu",
            "affiliation": "N",
            "endpointDescription": "gillgr@oregonstate.edu",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "gillgr@oregonstate.edu",
            "address_1": "1817 16th St",
            "city": "North Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "974592629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David Geels, QMHP
• Antonia Ortega Gerber, NP-PP
• Robert D Gibbs, OD
• Kevin Leonard Gibson, MS
• Jane Gilbert, M.D.
• Jennifer Gilroy
• Deborah Ann Girnt
• Albert Leroy Glick, QMHA
• Debra A. Graham, M.D.
• Janine Anselmo Granstrand

• Mental Health Counselor in North Bend, OR
• Providers in North Bend, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.