Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1750090130 Individual Practitioner Female Practitioner

Kimberly Ann Medlock

Counselor • Bend, OR

Professional Overview & Biography Verified Profile Summary

Kimberly Medlock is a registered healthcare professional specializing in Counselor in Bend, OR. Practice services are available at 2480 NE TWIN KNOLLS DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2480 Ne Twin Knolls Dr

Bend, OR 977016833

Telephone 5418481801
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor in Bend, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 24.0 Yrs
State Avg: 12.6 Yrs
Regional Practice Density
97 Specialists

Practicing in Bend, OR (4551 Statewide)

Telehealth Adoption Rate
1.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2022-11-15
Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
NPI 1013790518
NPI 1033809546
NPI 1033828728
NPI 1033907969
Colin Nettles

Counselor

NPI 1043943319
NPI 1063113694

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active November 15, 2022

NPI status registered as active in NPPES database

📍
Updated Practice Location November 15, 2022

Registered at 2480 NE TWIN KNOLLS DR, BEND, OR 977016833 (Tel: 5418481801)

📍
Updated Business Mailing Address November 15, 2022

Registered at 16187 DAWN RD, LA PINE, OR 977398842 (Tel: 5418481801)

👤
Provider Name / Credentials Updated November 15, 2022

Recorded as KIMBERLY MEDLOCK

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 15, 2022

Counselor

🟢
Initial NPI Registration & Enumeration November 15, 2022

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1750090130
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 15, 2022
Last Update: November 15, 2022
Sole Proprietor: Yes

Mailing Address

16187 Dawn Rd

La Pine, OR 977398842

Phone: 5418481801

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.