Individual provider Active NPI

James Bradshaw, MFT

  • Mental Health Counselor
  • Medford, OR
National Provider Identifier
1851783757
Registry record updated Sep 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1175 E Main St
Medford, OR 97504-7499
Phone
(541) 772-0127
NPI assigned
Mar 2, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X IMF82380 CA
Mental Health Counselor 101YM0800X OR Primary

Addresses

Primary practice location

1175 E Main St
Medford, OR 97504-7499

Mailing address

1175 E Main St
Medford, OR 97504-7499
Phone (541) 772-0127

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240221002603 OR Practitioner - Mental Health Counselor 3476997164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trinity Counseling Center LLCGroup PAC ID 7113378159, 5 clinicians

Practice addresses (Care Compare)

815 E Jackson St
Medford, OR 97504-6713
Phone (541) 245-2787

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
IMF82380CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Counseling Center, LLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Hutter & Seeley Psychological Services, P.C. PastSince Jan 1, 2024 Accepting new patients

Locations

815 E Jackson St
Medford, OR 97504
Phone (541) 245-2787

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1425254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1851783757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 E MAIN ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047499",
            "telephone_number": "541-772-0127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 E MAIN ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047499",
            "telephone_number": "541-772-0127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "JAMES",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-02",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF82380",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.