Individual provider Active NPI

Kelly Martin Murray, PHD

  • Psychologist
  • Eugene, OR
National Provider Identifier
1649462862
Registry record updated Apr 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2058 Issued in OR
Practice address
1892 Willamette St
Eugene, OR 97401-4044
Phone
(541) 345-8505
Fax
(541) 345-8810
NPI assigned
Aug 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Psychologist 103T00000X 2058 OR Primary

Addresses

Primary practice location

1892 Willamette St
Eugene, OR 97401-4044

Mailing address

1892 Willamette St
Eugene, OR 97401-4044
Phone (541) 345-0766

Other practice location 1

3995 Marcola Rd
Springfield, OR 97477-7948
Phone (541) 726-1465

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jun 6, 2024 through Jun 6, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2058ORMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1186790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712361600000",
    "number": "1649462862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1892 WILLAMETTE ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014044",
            "telephone_number": "541-345-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1892 WILLAMETTE ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014044",
            "telephone_number": "541-345-8505",
            "fax_number": "541-345-8810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3995 Marcola Rd",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OR",
            "postal_code": "974777948",
            "country_code": "US",
            "telephone_number": "541-726-1465",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MURRAY",
        "first_name": "KELLY",
        "middle_name": "MARTIN",
        "name_prefix": "Mrs.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-11",
        "last_updated": "2024-04-06",
        "certification_date": "2024-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "2058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.