Active NPI
Jill R Kaufmann, MS
- Marriage & Family Therapist
- Bend, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- T0957
- Practice address
- 2577 NE Courtney Dr
Bend, OR 97701-7638 - Phone
- (541) 322-7500
- Fax
- (541) 322-7565
- NPI assigned
- Jan 11, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 05-0008 | KY | |
| Marriage & Family Therapist | 106H00000X | T0957 | OR | Primary |
Addresses
Primary practice location
2577 NE Courtney Dr
Bend, OR 97701-7638
Mailing address
2577 NE Courtney Dr
Bend, OR 97701-7638
Phone (541) 322-7500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30615058 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR, KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Marriage and Family Therapist
- Education
- Other, 2004
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2196 3Rd Ave
New York, NY 10035-3501
66 W Flagler St
Suite 900
Miami, FL 33130-1812
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05-0008 | KY | MD | Marriage & Family Therapist |
| T0957 | OR | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deschutes County Oregon | Current | Accepting new patients | |
| Grow Healthcare Group PA | Marriage & Family Therapist | Current | Accepting new patients |
| Deschutes County Oregon | Current | Accepting new patients | |
| Deschutes County Oregon | Current | Accepting new patients |
Locations
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
312 S 4th St
Ste 700
Louisville, KY 40202
Phone (502) 628-5023
2577 NE Courtney Dr
Bend, OR 97701
Phone (541) 322-7400
10260 SW Greenburg Rd
Fl 4
Tigard, OR 97223
Phone (503) 405-9338
Organizations & group practices 4
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Bend, OR
- NPI 1235172180
-
- Mental Health Counselor
- Miami, FL
- NPI 1245845932
KY, Marriage & Family Therapist, OR
-
- Addiction (Substance Use Disorder) Counselor
- Bend, OR
- NPI 1366656068
-
- Health Educator
- Bend, OR
- NPI 1598323040
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406764800000",
"number": "1497805501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2577 NE COURTNEY DR",
"city": "BEND",
"state": "OR",
"postal_code": "977017638",
"telephone_number": "541-322-7500",
"fax_number": "541-322-7565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2577 NE COURTNEY DR",
"city": "BEND",
"state": "OR",
"postal_code": "977017638",
"telephone_number": "541-322-7500",
"fax_number": "541-322-7565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAUFMANN",
"first_name": "JILL",
"middle_name": "R",
"credential": "MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-11",
"last_updated": "2014-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "KY",
"license": "05-0008",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "OR",
"license": "T0957",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30615058",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2014; 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.