NPIMap

Organization Active NPI

Nibbus Combined Care LLC

  • Adult Mental Health Clinic/Center
  • Medford, OR
National Provider Identifier
1962288829
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
NIBBUS COMBINED CARE LLC
Practice address
1175 E Main St Ste 1B
Medford, OR 97504-7457
Phone
(458) 225-9990
NPI assigned
Sep 6, 2023
Organization subpart
Yes
Parent organization
NIBBUS COMBINED CARE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Authorized official

Name
Mrs. Brenda L WatsonNPI 1275991788
Title
Owner
Phone
(458) 225-9993

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

1175 E Main St Ste 1B
Medford, OR 97504-7457

Mailing address

1175 E Main St Ste 2F
Medford, OR 97504-7457
Phone (458) 225-9993

Other practice location 1

1520 S Peach St
Medford, OR 97501-4051
Phone (458) 658-9386

Other practice location 2

2240 Terrel Dr
Medford, OR 97501-8140
Phone (458) 226-5347

Other practice location 3

805 Amerman Dr
Phoenix, OR 97535-7729
Phone (458) 291-1603

Other practice location 4

1481 Kings Hwy
Medford, OR 97501-4010
Phone (458) 658-9643

Other names 1

  • NiBBuS CombiNed Care Outpatient Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Nibbus Combined Care LLC Dba New Wave RTH7 organizations share this tax ID, including this one
Part of
Nibbus Combined Care LLC Dba New Wave RTH

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1175 E Main St
Ste 1B
Medford, OR 97504
Phone (458) 225-9990

Practitioners & affiliated clinicians

Practitioners 11

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": "1693958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741219200000",
    "number": "1962288829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 E MAIN ST STE 2F",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047457",
            "telephone_number": "458-225-9993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 E MAIN ST STE 1B",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047457",
            "telephone_number": "458-225-9990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1520 S Peach St",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975014051",
            "country_code": "US",
            "telephone_number": "458-658-9386",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2240 Terrel Dr",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975018140",
            "country_code": "US",
            "telephone_number": "458-226-5347",
            "fax_number": "458-226-2010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "805 Amerman Dr",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "OR",
            "postal_code": "975357729",
            "country_code": "US",
            "telephone_number": "458-291-1603",
            "fax_number": "541-897-0106",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1481 Kings Hwy",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975014010",
            "country_code": "US",
            "telephone_number": "458-658-9643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NIBBUS COMBINED CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NIBBUS COMBINED CARE LLC",
        "enumeration_date": "2023-09-06",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "458-225-9993",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NiBBuS CombiNed Care Outpatient Clinic",
            "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 Mar 6, 2025; 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.