Active NPI
Brandon Oakley Boyd, CRM/QMHA-R
- Addiction (Substance Use Disorder) Counselor
- Portland, OR
National Provider Identifier
1881337756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 23-CRM-2069
- Practice address
- 1310 SW 17TH Ave
Portland, OR 97201-2522 - Phone
- (503) 231-2641
- Fax
- (503) 467-4077
- NPI assigned
- Apr 18, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 23-CRM-2069 | OR | Primary |
| Mental Health Counselor | 101YM0800X | 23-QMHA-R-3994 | OR |
Addresses
Primary practice location
1310 SW 17TH Ave
Portland, OR 97201-2522
Mailing address
1776 SW Madison St
Portland, OR 97205-1715
Phone (503) 224-1044
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500809444 | Medicaid | OR |
Other names 1
- Beau Boyd
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Unknown |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23-CRM-2069 | OR | MD | Addiction (Substance Use Disorder) Counselor |
| 23-QMHA-R-3994 | OR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696204800000",
"number": "1881337756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1776 SW MADISON ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972051715",
"telephone_number": "503-224-1044",
"fax_number": "503-621-2235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1310 SW 17TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972012522",
"telephone_number": "503-231-2641",
"fax_number": "503-467-4077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYD",
"first_name": "BRANDON",
"middle_name": "OAKLEY",
"credential": "CRM/QMHA-R",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-04-18",
"last_updated": "2023-10-02",
"certification_date": "2023-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OR",
"license": "23-CRM-2069",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "23-QMHA-R-3994",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500809444",
"state": "OR"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Unknown",
"affiliation": "N",
"address_1": "6400 SE Lake Rd Ste 175",
"city": "Portland",
"state": "OR",
"country_code": "US",
"postal_code": "972222137",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "BEAU",
"last_name": "BOYD",
"credential": "CRM/QMHA-R",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.