BROCK ANTHONY BUMGARNER (NPI# 1447800024) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447800024 |
| Entity Type | Individual |
| Full Name | BROCK ANTHONY BUMGARNER |
| Credential | QMHP |
| Practice Address |
1181 Sw Ramsey Ave Grants Pass OR 97527-5835 |
| Mailing Address |
1215 Sw G St Grants Pass OR 97526-2544 |
| Practice Telephone | 5414762373 |
| Mailing Telephone | 5414762373 |
| Enumeration Date | 2019-09-16 |
| Last Update Date | 2019-09-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
OR | Behavioral Health & Social Service Providers |
| Street Address |
1181 SW RAMSEY AVE |
| City | GRANTS PASS |
| State | OR |
| Zip Code | 97527-5835 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114013919 | Sharon Kay Schmidt | Registered Nurse | 1181 Sw Ramsey Ave, Grants Pass, OR 97527 | 2006-10-05 |
| 1841891348 | Kayla Brooke Malik | Behavioral Analyst | 1181 Sw Ramsey Ave, Grants Pass, OR 97527-5835 | 2020-11-03 |
| 1043830532 | Robert D Jaynes | Counselor | 1181 Sw Ramsey Ave, Grants Pass, OR 97527-5835 | 2020-04-24 |
| 1851924187 | Alexa S Backanen | Counselor | 1181 Sw Ramsey Ave, Grants Pass, OR 97527-5835 | 2020-02-14 |
| 1861023160 | Crystian Villa | Counselor | 1181 Sw Ramsey Ave, Grants Pass, OR 97527-5835 | 2020-01-27 |
| 1184263394 | Mary Mcnamee | Counselor | 1181 Sw Ramsey Ave, Grants Pass, OR 97527-5835 | 2020-01-06 |
| 1891333563 | Amy Merlee Carter | Behavior Technician | 1181 Sw Ramsey Ave, Grants Pass, OR 97527-5835 | 2019-12-12 |
| 1679114680 | Marisabel Rodriguez | Counselor | 1181 Sw Ramsey Ave, Grants Pass, OR 97527-5835 | 2019-10-01 |
| 1518517556 | Britni Nichole Hughes | Behavior Technician | 1181 Sw Ramsey Ave, Grants Pass, OR 97527-5835 | 2019-09-11 |
| 1205489994 | Options for Southern Oregon | Case Management | 1181 Sw Ramsey Ave, Grants Pass, OR 97527-5835 | 2019-07-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528618600 | Sandra J Campos | Technician | 365 Sleepy Hollow Loop, Grants Pass, OR 97527 | 2019-09-19 |
| 1720501026 | Kelly Bates | Massage Therapist | 501 Cheney Creek Rd, Grants Pass, OR 97527 | 2017-07-19 |
| 1740650134 | Sara Brelsford | Nurse Practitioner | 1075 Sw Grandview Avenue, Suite 200, Grants Pass, OR 97527 | 2015-09-29 |
| 1962816348 | Kimberly Hathaway | Counselor | 320 Ramsey Place, Grants Pass, OR 97527 | 2014-06-13 |
| 1801216999 | Christina Ann Marie Schultz | Massage Therapist | 242 Curtis Drive, Grants Pass, OR 97527 | 2014-04-16 |
| 1013343359 | Shaunte Angelique Duron | Counselor | 711 Sw Ramsey Avenue, Grants Pass, OR 97527 | 2013-09-18 |
| 1063848547 | Megan Faye Armstrong | Behavioral Analyst | 715 Ramsey Aveenue, Grants Pass, OR 97527 | 2013-09-17 |
| 1124454608 | Mark Albert Cook | Behavioral Analyst | 1153 Sw Cal Allen Lane, Grants Pass, OR 97527 | 2013-09-17 |
| 1952741969 | Mitchell K Sheeler | Denturist | 1850 Williams Hwy, Grants Pass, OR 97527 | 2013-07-05 |
| 1790038339 | White City Vamc | Clinic/Center | 1877 Williams Highway, Grants Pass, OR 97527 | 2012-10-19 |
| Find all providers in zip 97527 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932708559 | Laurie Sue Urbach | Counselor | 501 Sw Western Ave, Grants Pass, OR 97526-5811 | 2020-10-23 |
| 1750988713 | Priscilla Ann Stack | Counselor | 214 Nw 3rd St, Grants Pass, OR 97526-1913 | 2020-10-02 |
| 1164076469 | Alicia Yvonne Hansen | Counselor | 1055 Clarey St., Grants Pass, OR 97526 | 2019-07-25 |
| 1063996072 | Daniel Dirk | Counselor | 777 Ne 7th St Ste 107, Grants Pass, OR 97526-1632 | 2018-09-17 |
| 1801347612 | Maci Wageman | Counselor | 1215 Sw G St Grants Pass Oregon 97526, Grants Pass, OR 97526 | 2016-10-17 |
| 1982150793 | Tanya White | Counselor | 402 Nw Fstreet, Grants Pass, OR 97526 | 2016-08-31 |
| 1336557388 | Sonia Leamons | Counselor | 1331 Se Herrick Ln, Grants Pass, OR 97526-4015 | 2014-07-22 |
| 1962816348 | Kimberly Hathaway | Counselor | 320 Ramsey Place, Grants Pass, OR 97527 | 2014-06-13 |
| 1972920668 | Tressi Innana Albee | Counselor | 121 Ne A Street, Suite D, Grants Pass, OR 97526 | 2014-03-20 |
| 1013343359 | Shaunte Angelique Duron | Counselor | 711 Sw Ramsey Avenue, Grants Pass, OR 97527 | 2013-09-18 |
| Find all providers in GRANTS PASS | ||||
| City | GRANTS PASS |
| Zip Code | 97527 |
Please comment or provide details below to improve the information on BROCK ANTHONY BUMGARNER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.