Active NPI
Mutinta Kalambo
- Counselor
- Grants Pass, OR
National Provider Identifier
1912457490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 1750 Nebraska Ave
Grants Pass, OR 97527-5700 - Phone
- (541) 956-4943
- NPI assigned
- Oct 10, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Counselor | 101Y00000X | OR | Primary |
Addresses
Primary practice location
1750 Nebraska Ave
Grants Pass, OR 97527-5700
Mailing address
715 SW Ramsey Ave
Grants Pass, OR 97527-5500
Phone (541) 778-4613
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kairos Northwest | Past | Accepting new patients |
Organizations & group practices 1
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": "1476057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486857600000",
"number": "1912457490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "715 SW RAMSEY AVE",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975275500",
"telephone_number": "541-778-4613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1750 NEBRASKA AVE",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975275700",
"telephone_number": "541-956-4943"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KALAMBO",
"first_name": "MUTINTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-10-10",
"last_updated": "2017-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "OR",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grants Pass, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.