Individual provider Active NPI

James Sidney Stumbo, PH.D., LMFT

  • Marriage & Family Therapist
  • Medford, OR
National Provider Identifier
1831309301
Registry record updated Jan 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
T0192 Issued in OR
Practice address
3550 National Dr
Medford, OR 97504-4148
Phone
(541) 613-6667
Fax
(503) 419-4662
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2019

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 T0192 OR Primary

Addresses

Primary practice location

3550 National Dr
Medford, OR 97504-4148

Mailing address

PO Box 503010
White City, OR 97503-0813
Phone (541) 234-4781

Other identifiers 1

IdentifierTypeStateIssuer
500698785MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T0192ORMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547078400000",
    "number": "1831309301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 503010",
            "city": "WHITE CITY",
            "state": "OR",
            "postal_code": "975030813",
            "telephone_number": "541-234-4781",
            "fax_number": "503-419-4662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 NATIONAL DR",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044148",
            "telephone_number": "541-613-6667",
            "fax_number": "503-419-4662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUMBO",
        "first_name": "JAMES",
        "middle_name": "SIDNEY",
        "name_prefix": "Dr.",
        "credential": "PH.D., LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2019-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "T0192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500698785",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jan 10, 2019; 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.