Sheffie Dan Surber Jr., LPN

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2575 Westgate BLDG 13
Pendleton, OR 97801-9613

Phone

(541) 429-8721

Fax

(541) 429-8720

NPI assigned

Apr 7, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586390400000",
    "number": "1740819002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3587 HEATHROW WAY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044004",
            "telephone_number": "541-858-8170",
            "fax_number": "541-858-8167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 WESTGATE BLDG 13",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978019613",
            "telephone_number": "541-429-8721",
            "fax_number": "541-429-8720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURBER",
        "first_name": "SHEFFIE",
        "middle_name": "DAN",
        "name_suffix": "Jr.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-07",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OR",
            "license": "20030441LPN",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven L. Neal, MD, Facs, Inc.
• Jennah Shae Stobie, PA-C
• Stonewall Behavioral Health
• Stonewall Behavioral Health & Mental Wellness
• Mariah B Story, CADC I
• Cheryl Swales, QMHA
• Dawn Swan
• Francis E Szumski, DO
• Cali Marie Taggart
• Bobi D Tallman

• Mental Health Counselor in Pendleton, OR
• Providers in Pendleton, 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 Apr 9, 2020; 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.