Active NPI
MD Clinical Holdings, LLC
- Pediatric Neurodevelopmental Disabilities Physician
- Medford, OR
National Provider Identifier
1992673800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Neurodevelopmental Disabilities Physician
- Legal business name
- MD CLINICAL HOLDINGS, LLC
- Practice address
- 891 Ohare Pkwy
Medford, OR 97504-4005 - Phone
- (360) 909-7442
- NPI assigned
- Oct 23, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jake Mahon, PHD
- Title
- Owner
- Phone
- (541) 654-1776
Specialties & licenses 12
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | |||
| Clinical Child & Adolescent Psychologist | 103TC2200X | |||
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | |||
| Clinical Social Worker | 1041C0700X | |||
| Assistant Behavior Analyst | 106E00000X | |||
| Behavior Technician | 106S00000X | |||
| Pediatric Neurodevelopmental Disabilities Physician | 2080P0008X | Primary | ||
| Child & Adolescent Psychiatry Physician | 2084P0804X | |||
| Pediatric Physical Therapist | 2251P0200X | |||
| Feeding, Eating & Swallowing Occupational Therapist | 225XF0002X | |||
| Pediatric Occupational Therapist | 225XP0200X | |||
| Speech-Language Pathologist | 235Z00000X |
Addresses
Primary practice location
891 Ohare Pkwy
Medford, OR 97504-4005
Mailing address
891 Ohare Pkwy
Medford, OR 97504-4005
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1761177600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1780358400000",
"number": "1992673800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "891 OHARE PKWY",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975044005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "891 OHARE PKWY",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975044005",
"telephone_number": "360-909-7442"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MD CLINICAL HOLDINGS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-10-23",
"last_updated": "2026-06-02",
"certification_date": "2026-06-02",
"status": "A",
"authorized_official_last_name": "MAHON",
"authorized_official_first_name": "JAKE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "541-654-1776",
"authorized_official_credential": "PHD"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TM1800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "106E00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Assistant Behavior Analyst",
"state": null,
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "2080P0008X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics, Neurodevelopmental Disabilities",
"state": null,
"license": null,
"primary": true
},
{
"code": "2084P0804X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": null,
"license": null,
"primary": false
},
{
"code": "2251P0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist, Pediatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "225XF0002X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist, Feeding, Eating & Swallowing",
"state": null,
"license": null,
"primary": false
},
{
"code": "225XP0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist, Pediatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": false
}
],
"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 Jun 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.