Individual provider Active NPI

Kristene Elizabeth Maddux

  • Mental Health Counselor
  • Eugene, OR
National Provider Identifier
1902142516
Registry record updated Dec 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
550 River Rd
Eugene, OR 97404-3212
Phone
(541) 505-5485
NPI assigned
Dec 31, 2012
Last updated
Dec 31, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X OR Primary

Addresses

Primary practice location

550 River Rd
Eugene, OR 97404-3212

Mailing address

550 River Rd
Eugene, OR 97404-3212
Phone (541) 505-5485

Other names 1

  • Kristene Elizabeth Todd Former name

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": "1356912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356912000000",
    "number": "1902142516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 RIVER RD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974043212",
            "telephone_number": "541-505-5485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 RIVER RD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974043212",
            "telephone_number": "541-505-5485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDUX",
        "first_name": "KRISTENE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-31",
        "last_updated": "2012-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTENE",
            "last_name": "TODD",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2012; 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.