MR. MICHAEL PETER HIGGINBOTHAM II (NPI# 1538603618) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538603618 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL PETER HIGGINBOTHAM II |
| Practice Address |
233 Ne B St Ste 201 Grants Pass OR 97526-2108 |
| Practice Telephone | 5415007111 |
| Practice Fax Number | 5415079118 |
| Mailing Telephone | 5415007111 |
| Mailing Fax Number | 5415079118 |
| Enumeration Date | 2016-12-08 |
| Last Update Date | 2020-01-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | R4989 | OR | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 149 S Main St, Phoenix, OR 975356631 | 5415354133 | 5415355458 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194050906 | Michael Higginbotham | Social Worker | 11582 Tivoli Ln, Saint Louis, MO 63146-3500 | 2009-10-13 |
| 1720296395 | Michael Higginbotham | Social Worker | 302 Blueberry Ct, Marlton, NJ 08053-1015 | 2007-05-18 |
| 1508984188 | Michael T Higginbotham | Dentist | 3710 E. Main, Suite K, Blytheville, AR 72315 | 2007-03-26 |
| 1619992377 | Michael S Higginbotham | Family Medicine | 1002 Schneider Dr Ste 104, Malvern, AR 72104-4823 | 2006-07-13 |
| 1174084990 | Michael Higginbotham | Student in an Organized Health Care Education/Training Program | 119 Oakfield Dr, Brandon, FL 33511-5779 | 2019-03-26 |
| 1346505542 | Michael Richard Higginbotham | Dentist | 25916 Dequindre Rd, Warren, MI 48091-6112 | 2012-07-12 |
| 1336188150 | Michael B Higginbotham | Internal Medicine | 2301 House Ave, Cheyenne, WY 82001-3176 | 2006-06-06 |
| Street Address |
233 NE B ST STE 201 |
| City | GRANTS PASS |
| State | OR |
| Zip Code | 97526-2108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598307415 | Christina Rivers | Counselor | 233 Ne B St Ste 201, Grants Pass, OR 97526-2108 | 2019-10-11 |
| 1639646391 | Amanda Mae Metcalf | Student in an Organized Health Care Education/Training Program | 233 Ne B St Ste 201, Grants Pass, OR 97526-2108 | 2018-10-30 |
| 1053821470 | Kathryn Dougherty | Counselor | 233 Ne B St Ste 201, Grants Pass, OR 97526 | 2017-10-11 |
| 1164952164 | Rising Phoenix Counseling Services, LLC | Clinic/Center | 233 Ne B St Ste 201, Grants Pass, OR 97526-2108 | 2017-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205476777 | Kyla M Mccormick | Peer Specialist | 109 Nw Manzanita Avenue, Grants Pass, OR 97526 | 2020-01-13 |
| 1164076469 | Alicia Yvonne Hansen | Counselor | 1055 Clarey St., Grants Pass, OR 97526 | 2019-07-25 |
| 1841842598 | Michael Liam Reynolds, Dds, LLC | Dentist | 984 Ne 8th Street, Grants Pass Oregon, Grants Pass, OR 97526 | 2019-07-12 |
| 1881254746 | Brandi Mccrorey | Counselor | 418 Ne 6th Street, Suite 102, Grants Pass, OR 97526 | 2019-06-13 |
| 1700364502 | Premier Community Supports, LLC. | Day Training, Developmentally Disabled Services | 1439 Ne 6th St Ste C, Grants Pass, OR 97526 | 2018-08-02 |
| 1821584509 | Stefani Mcintyre | Massage Therapist | 1590 Se N Street, Warehouse #1574, Grants Pass, OR 97526 | 2018-07-06 |
| 1114467438 | Sandra P Martin | Chiropractor | 333 Sw 5th St. Suite B, Grants Pass, OR 97526 | 2017-03-06 |
| 1801347612 | Maci Wageman | Counselor | 1215 Sw G St Grants Pass Oregon 97526, Grants Pass, OR 97526 | 2016-10-17 |
| 1902353907 | Optimal Health of Southern Oregon, LLC | Family Medicine | 1600 Nw 6th St South Suite, Grants Pass, OR 97526 | 2016-09-07 |
| 1982150793 | Tanya White | Counselor | 402 Nw Fstreet, Grants Pass, OR 97526 | 2016-08-31 |
| Find all providers in zip 97526 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164956298 | Tabitha Fish | Student in an Organized Health Care Education/Training Program | 1877 Medart Ln, Grants Pass, OR 97527-6298 | 2017-04-15 |
| 1639646391 | Amanda Mae Metcalf | Student in an Organized Health Care Education/Training Program | 233 Ne B St Ste 201, Grants Pass, OR 97526-2108 | 2018-10-30 |
| 1699159103 | Zachary Goodwiler | Student in an Organized Health Care Education/Training Program | 544 Union Ave, Grants Pass, OR 97527-5544 | 2015-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902407265 | Daisy May Macgilbert | Student in an Organized Health Care Education/Training Program | 15698 Sw Greenfield Dr, Tigard, OR 97224-3828 | 2020-11-03 |
| 1215536602 | Dario J Lapoma | Student in an Organized Health Care Education/Training Program | 1305 Se Birch St, Portland, OR 97214-5335 | 2020-10-18 |
| 1497354880 | Justin Tyler Miracle | Student in an Organized Health Care Education/Training Program | 1421 Nw Cleveland Ave, Corvallis, OR 97330-2015 | 2020-10-18 |
| 1740888155 | Charles Samuel Goldfoot | Student in an Organized Health Care Education/Training Program | 1650 Nw 13th Ave Apt 109, Portland, OR 97209-3694 | 2020-10-16 |
| 1396343992 | Shelby Taylor Bowerly | Student in an Organized Health Care Education/Training Program | 4522 Ne Ainsworth St, Portland, OR 97218-1322 | 2020-10-15 |
| 1821696816 | Nancy Sierra Ferrer | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd # Or97239, Portland, OR 97239-3011 | 2020-10-13 |
| 1437757663 | David Gallacher | Student in an Organized Health Care Education/Training Program | 3303 S Bond Ave # 1, Portland, OR 97239-4501 | 2020-10-10 |
| 1366049777 | Carolyn Evans | Student in an Organized Health Care Education/Training Program | 80 Ne 14th Ave Apt 314, Portland, OR 97232-3568 | 2020-10-08 |
| 1871100503 | Mason P Haye | Student in an Organized Health Care Education/Training Program | 21430 Miles Dr, West Linn, OR 97068-2880 | 2020-09-27 |
| 1760098628 | Reid Marion | Student in an Organized Health Care Education/Training Program | 21420 Colt Rd, Klamath Falls, OR 97603-9803 | 2020-09-16 |
| Find all providers with the same taxonomy | ||||
| City | GRANTS PASS |
| Zip Code | 97526 |
Please comment or provide details below to improve the information on MR. MICHAEL PETER HIGGINBOTHAM II.
| 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.