Individual provider Active NPI

Gregory Simmons

  • Mental Health Counselor
  • Medford, OR
National Provider Identifier
1942421003
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
201 W Main St Ste 4B
Medford, OR 97501-2734
Phone
(541) 414-1720
Fax
(541) 414-1721
NPI assigned
May 2, 2007
Last updated
Sep 12, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2019

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 NU Primary

Addresses

Primary practice location

201 W Main St Ste 4B
Medford, OR 97501-2734

Mailing address

201 W Main St Ste 4B
Medford, OR 97501-2734
Phone (541) 414-1720

Other practice location 1

829 Chief Eddy Hoffman Hwy
Bethel, AK 99559
Phone (907) 543-6100

Other identifiers 1

IdentifierTypeStateIssuer
MH0150MedicaidAK

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

OrganizationSpecialtyStatusNew patients
Family Solutions CurrentSince Dec 3, 2023 Accepting new patients

Locations

201 W Main St
Ste 4B
Medford, OR 97501
Phone (541) 281-9026

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1942421003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W MAIN ST STE 4B",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975012734",
            "telephone_number": "541-414-1720",
            "fax_number": "541-414-1721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W MAIN ST STE 4B",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975012734",
            "telephone_number": "541-414-1720",
            "fax_number": "541-414-1721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "829 Chief Eddy Hoffman Hwy",
            "address_purpose": "LOCATION",
            "city": "Bethel",
            "state": "AK",
            "postal_code": "99559",
            "country_code": "US",
            "telephone_number": "907-543-6100",
            "fax_number": "907-543-6008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "GREGORY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MH0150",
            "state": "AK"
        }
    ],
    "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 Sep 12, 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.

Verify at the official NPI Registry.