NPIMap

Organization Active NPI

Jackson County Community Justice

  • Counselor
  • Medford, OR
National Provider Identifier
1649645151
Registry record updated Dec 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
JACKSON COUNTY COMMUNITY JUSTICE
Practice address
609 W 10TH St
Medford, OR 97501-3106
Phone
(541) 774-4812
Fax
(541) 774-4888
NPI assigned
Dec 9, 2015
Last updated
Dec 9, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2015

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

Authorized official

Name
Mr. Donald Scott MickeyNPI 1952774101
Title
Supervisor
Phone
(541) 774-4812

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X Primary

Addresses

Primary practice location

609 W 10TH St
Medford, OR 97501-3106

Mailing address

609 W 10TH St
Medford, OR 97501-3106
Phone (541) 774-4812

Other names 1

  • Juvenile Division CBT Program Other name

National Provider Directory

National Provider Directory
Tax ID family
Jackson County Mental H8 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1449619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449619200000",
    "number": "1649645151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 W 10TH ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975013106",
            "telephone_number": "541-774-4812",
            "fax_number": "541-774-4888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 W 10TH ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975013106",
            "telephone_number": "541-774-4812",
            "fax_number": "541-774-4888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON COUNTY COMMUNITY JUSTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-09",
        "last_updated": "2015-12-09",
        "status": "A",
        "authorized_official_last_name": "MICKEY",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "541-774-4812",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Juvenile Division CBT Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.