Individual provider Active NPI

Kurtis James Mitchell, QMHP LMFT

  • Marriage & Family Therapist
  • Eugene, OR
National Provider Identifier
1619043841
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
T0449 Issued in OR
Practice address
576 Olive St Suite 307
Eugene, OR 97401
Phone
(541) 344-7303
NPI assigned
Nov 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X T0449 OR Primary

Addresses

Primary practice location

576 Olive St Suite 307
Eugene, OR 97401

Mailing address

576 Olive St Suite 307
Eugene, OR 97401
Phone (541) 344-7303

Other identifiers 1

IdentifierTypeStateIssuer
037759MedicaidOR

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
I20240430004375 OR Practitioner - Marriage and Family Therapist 4880034339 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

576 Olive St
Suite 307
Eugene, OR 97401-2995
Phone (541) 344-7303

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Direction Service CurrentSince Jan 31, 2024 Accepting new patients

Locations

576 Olive St
Ste 307
Eugene, OR 97401
Phone (541) 344-7303

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/directionservice/r4/

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619043841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 OLIVE ST SUITE 307",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "97401",
            "telephone_number": "541-344-7303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "576 OLIVE ST SUITE 307",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "97401",
            "telephone_number": "541-344-7303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "KURTIS",
        "middle_name": "JAMES",
        "credential": "QMHP LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "T0449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037759",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.