JEREMY GORDON ALLEN (NPI# 1003308917) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003308917 |
| Entity Type | Individual |
| Full Name | JEREMY GORDON ALLEN |
| Practice Address |
2555 Silverton Rd Ne Salem OR 97301-0837 |
| Mailing Address |
1115 Madison St Ne # 222 Salem OR 97301-7862 |
| Practice Telephone | 9712832776 |
| Mailing Telephone | 9712832776 |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2018-10-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 172V00000X | Community Health Worker | Other Service Providers | ||
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1115 Madison St Ne # 222, Salem, OR 973017862 | 9712832776 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558768747 | Jeremy Robert Allen | Marriage & Family Therapist | 5181 Ward Rd Ste 201, Wheat Ridge, CA 80033-2074 | 2014-12-03 |
| 1386774057 | Jeremy W Allen | Dentist | 908 W 5th St, Suite 114, London, KY 40741-2417 | 2007-03-06 |
| 1487704508 | Jeremy Peter Allen | Counselor | 463 William Street, Buffalo, NY 14204-1811 | 2007-01-11 |
| 1386996593 | Jeremy Jon Allen | Pharmacist | 1500 Washington St, Two Rivers, WI 54241-3045 | 2012-10-11 |
| 1124205661 | Jeremy Allen | Physician Assistant | 100 Grand St, New Britain, CT 06052-2016 | 2008-01-28 |
| 1447287115 | Jeremy Allen | Family Medicine | 70 Plaza Dr, Pell City, AL 35125 | 2006-06-27 |
| Street Address |
2555 SILVERTON RD NE |
| City | SALEM |
| State | OR |
| Zip Code | 97301-0837 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104331370 | Christina E Higgins Korkow | Peer Specialist | 2555 Silverton Rd Ne, Salem, OR 97301-0837 | 2017-12-08 |
| 1396358859 | Tealah Mae Meyer | Peer Specialist | 2555 Silverton Rd Ne, Salem, OR 97301-0837 | 2020-08-25 |
| 1679053896 | Stephen Joseph Grady | Peer Specialist | 2555 Silverton Rd Ne, Salem, OR 97301-0837 | 2018-08-16 |
| 1962981340 | Trever Wade Houghton | Peer Specialist | 2555 Silverton Rd Ne, Salem, OR 97301-0837 | 2018-08-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205450970 | Jehan Seals | Behavior Technician | 3400 State St Set G750, Salem, OR 97301 | 2020-05-29 |
| 1093335929 | Sterling Recovery, LLC | Dietitian, Registered | 3758 Amber St Ne #105, Salem, OR 97301 | 2020-04-21 |
| 1760018360 | Riverfront Mental Health LLC | Counselor | 338 State St, Suite 985, Salem, OR 97301 | 2020-03-16 |
| 1871126888 | Amity Beth Haddon Maxwell | Social Worker | Oregon State Hospital, 2600 Center St Ne, Salem, OR 97301 | 2020-02-18 |
| 1861042632 | Brenda Grizelda Vargas | Behavioral Analyst | 3400 State Ste Ste G750, Salem, OR 97301 | 2019-09-13 |
| 1588213177 | Natalie Stone | Registered Nurse | 2045 Siverton Rd Ne, Salem, OR 97301 | 2019-09-06 |
| 1588228720 | Jeramy Disenso | Counselor | 270 Cottage St Ne, Salem, OR 97301 | 2019-04-23 |
| 1801353297 | Gwendolyn Kersey | Registered Nurse | 2600 Center St Ne Oregon State Hospital, Salem, OR 97301 | 2019-02-21 |
| 1841769114 | Spine Clinic PC | Massage Therapist | 1281 Lancaster Drive Ne, Salem, OR 97301 | 2018-11-16 |
| 1013482132 | Kellie Linn Hansen | Physical Therapist | 4049 Market St Se, Salem, OR 97301 | 2018-10-04 |
| Find all providers in zip 97301 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528677820 | Charice Monette | Peer Specialist | 4151 Kacey Cir Ne, Salem, OR 97305-4504 | 2020-07-23 |
| 1821649336 | Christopher Adam Handy | Peer Specialist | 3050 Park Ave Ne, Salem, OR 97301-8615 | 2019-09-25 |
| 1922505767 | Amy Nicole Cozad | Peer Specialist | 4275 Commercial St Se Ste 180, Salem, OR 97302-4087 | 2018-04-09 |
| 1649785817 | Keileigh Joy Dull | Peer Specialist | 3213 Center St Ne, Salem, OR 97301-4666 | 2017-12-08 |
| 1104331370 | Christina E Higgins Korkow | Peer Specialist | 2555 Silverton Rd Ne, Salem, OR 97301-0837 | 2017-12-08 |
| 1437682044 | Debra Janae Rice | Peer Specialist | 2555 Silverton Rd Ne Ste C, Salem, OR 97301-0837 | 2017-04-10 |
| 1952834194 | Brian Smith | Peer Specialist | 769 Hawthorne Ave Ne, Salem, OR 97301-4623 | 2017-04-05 |
| 1588013577 | Sarah Harris | Peer Specialist | 4255 32nd Pl Ne, Salem, OR 97301-6735 | 2016-06-09 |
| 1194187476 | Tammi Paul | Peer Specialist | 1300 Broadway St Ne Ste 403, Salem, OR 97301-1420 | 2016-03-24 |
| 1710343926 | Teresa Anne Sims | Peer Specialist | 1599 State Street Ne, Salem, OR 97301 | 2016-01-05 |
| Find all providers in SALEM | ||||
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| 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.