Jesse Michael Nussbaum, BA

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

1750 Nebraska Ave BLDG B
Grants Pass, OR 97527-5700

Phone

(541) 476-3302

NPI assigned

Mar 25, 2012

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

Credentials

Bachelor of Arts

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

{
    "created_epoch": "1332633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521849600000",
    "number": "1780950691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 SW RAMSEY AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275500",
            "telephone_number": "541-956-4943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 NEBRASKA AVE BLDG B",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275700",
            "telephone_number": "541-476-3302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "715 SW Ramsey Ave",
            "address_purpose": "LOCATION",
            "city": "Grants Pass",
            "state": "OR",
            "postal_code": "975275500",
            "country_code": "US",
            "telephone_number": "541-476-3302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NUSSBAUM",
        "first_name": "JESSE",
        "middle_name": "MICHAEL",
        "credential": "BA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-25",
        "last_updated": "2018-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2018; 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.