Active NPI
Tyrone McDonald
- Addiction (Substance Use Disorder) Counselor
- Medford, OR
National Provider Identifier
1861850463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 234 W 5TH St
Medford, OR 97501-2611 - Phone
- (541) 858-4642
- Fax
- (541) 734-2410
- NPI assigned
- Feb 10, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | OR | Primary |
Addresses
Primary practice location
234 W 5TH St
Medford, OR 97501-2611
Mailing address
300 W Main St
Medford, OR 97501-2756
Phone (541) 772-1777
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556841600000",
"number": "1861850463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 W MAIN ST",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975012756",
"telephone_number": "541-772-1777",
"fax_number": "541-734-2410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "234 W 5TH ST",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975012611",
"telephone_number": "541-858-4642",
"fax_number": "541-734-2410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONALD",
"first_name": "TYRONE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-02-10",
"last_updated": "2019-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OR",
"license": null,
"primary": true
}
],
"identifiers": [],
"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 May 3, 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.