NPIMap

Organization Active NPI

Shannon Sheats LLC

  • Mental Health Counselor
  • Medford, OR
National Provider Identifier
1962111401
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
SHANNON SHEATS LLC
Doing business as
Siskiyou Behavioral Health
Practice address
328 S Central Ave Ste 101
Medford, OR 97501-7274
Phone
(541) 500-8195
Fax
(540) 500-8196
NPI assigned
Nov 22, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Authorized official

Name
Michael Sheats
Title
Office Manager
Phone
(541) 631-8634

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

328 S Central Ave Ste 101
Medford, OR 97501-7274

Mailing address

328 S Central Ave Ste 101
Medford, OR 97501-7274
Phone (541) 500-8195

Other names 1

  • Siskiyou Behavioral Health Doing business as

National Provider Directory

National Provider Directory

Locations

328 S Central Ave
Ste 101
Medford, OR 97501
Phone (541) 500-8195

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1669075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669075200000",
    "number": "1962111401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 S CENTRAL AVE STE 101",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975017274",
            "telephone_number": "541-500-8195",
            "fax_number": "540-500-8196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 S CENTRAL AVE STE 101",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975017274",
            "telephone_number": "541-500-8195",
            "fax_number": "540-500-8196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANNON SHEATS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-22",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A",
        "authorized_official_last_name": "SHEATS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "541-631-8634"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Siskiyou Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 22, 2022; 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.