Active NPI
Martin Mares
- Mental Health Counselor
- Medford, OR
National Provider Identifier
1932730470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 1175 E Main St Ste C1
Medford, OR 97504-7457 - Phone
- (541) 772-0127
- Fax
- (541) 772-0966
- NPI assigned
- Feb 3, 2020
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
1175 E Main St Ste C1
Medford, OR 97504-7457
Mailing address
1750 Nebraska Ave
Grants Pass, OR 97527-5700
Phone (541) 956-4943
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 | Current | Accepting new patients |
Locations
1750 Nebraska Ave
Grants Pass, OR 97527
Phone (541) 474-5579
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": "1580688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580688000000",
"number": "1932730470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1750 NEBRASKA AVE",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975275700",
"telephone_number": "541-956-4943",
"fax_number": "541-295-3085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1175 E MAIN ST STE C1",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975047457",
"telephone_number": "541-772-0127",
"fax_number": "541-772-0966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARES",
"first_name": "MARTIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-02-03",
"last_updated": "2020-02-03",
"certification_date": "2020-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"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 Feb 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.