TIMOTHY ROADEN (NPI# 1376076331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1376076331 |
Entity Type | Individual |
Full Name | TIMOTHY ROADEN |
Practice Address |
356 Ne Faulconer Ct Sheridan OR 97378-1255 |
Practice Telephone | 9712414466 |
Mailing Telephone | 9712414466 |
Enumeration Date | 2017-04-06 |
Last Update Date | 2017-04-06 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 175T00000X | Peer Specialist | Other Service Providers |
Street Address |
356 NE FAULCONER CT |
City | SHERIDAN |
State | OR |
Zip Code | 97378-1255 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386757193 | Andrew Barnes Grasley | General Practice | 2702 Sw Ballston Road, Sheridan, OR 97378 | 2006-08-16 |
1902878333 | Kenneth A Kelley | Chiropractor | 639 W Main, Sheridan, OR 97378 | 2006-02-01 |
1790951440 | Sheridan Family Chiropractic PC | Chiropractor | 639 W Main, Sheridan, OR 97378 | 2008-05-02 |
1265959563 | Bettina Tamice Moore | Counselor | 901 W Main St, Sheridan, OR 97378-1003 | 2017-08-28 |
1467837344 | Cody Charron | Dentist | 411 W Main St, Sheridan, OR 97378-1117 | 2015-07-21 |
1801918255 | Kenneth G Mize Dmdpc | Dentist | 411 W Main St, Sheridan, OR 97378-1117 | 2007-04-05 |
1255338638 | Kenneth G Mize | Dentist | 411 W Main St, Sheridan, OR 97378-1117 | 2005-06-30 |
1689047680 | Thunderstruck Farms Inc. | Chiropractor | 639 W Main St, Sheridan, OR 97378-1121 | 2015-11-12 |
1013390939 | Tina Hargrove | Chiropractor | 639 W Main St, Sheridan, OR 97378-1121 | 2015-07-09 |
1598951634 | Julie Lynn Detamore | Acupuncturist | 552 Nw Evans St, Sheridan, OR 97378-1208 | 2007-09-21 |
Find all providers in zip 97378 |
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 |
---|---|---|---|---|
1841760410 | Christopher Michael Evans | Peer Specialist | 1221 W 5th Street, Sheridan, WY 82801 | 2018-11-27 |
1346850781 | Daniel Laurencel Aguilar | Peer Specialist | 3460 S Federal Blvd, Sheridan, CO 80110-1967 | 2020-07-31 |
1255998423 | Tanya A Tsukas | Peer Specialist | 1701 W 5th St Ste C, Sheridan, WY 82801-2749 | 2019-05-23 |
1053814624 | Jacqui Morel | Peer Specialist | 2161 Coffeen Ave Ste 402, Sheridan, WY 82801-5771 | 2018-03-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487255576 | Thomas Roy Hooks | Peer Specialist | 1221 Sw 11th Ave Apt 102, Portland, OR 97205-2143 | 2020-11-04 |
1578162145 | Kenneth Branson | Peer Specialist | 389 Sw Scalehouse Ct Ste 130, Bend, OR 97702-3241 | 2020-10-23 |
1962000554 | Dawn Marks | Peer Specialist | 21440 Se Stark St, Gresham, OR 97030-2024 | 2020-10-15 |
1679188080 | Michelle Marie Bunkers | Peer Specialist | 20517 Jacklight Ln, Bend, OR 97702-2971 | 2020-09-11 |
1538773155 | Mamie Nzigire Zagabe | Peer Specialist | 605 Se Cesar Estrada Chavez Blvd, Portland, OR 97214 | 2020-09-01 |
1528677820 | Charice Monette | Peer Specialist | 4151 Kacey Cir Ne, Salem, OR 97305-4504 | 2020-07-23 |
1841810322 | Ariana Lee May | Peer Specialist | 1601 Olive St Apt 1008, Eugene, OR 97401-3985 | 2020-04-24 |
1982237236 | Jessica M Montoya | Peer Specialist | 235 Se Knowledge St, Prineville, OR 97754-2362 | 2020-02-14 |
1134752579 | Lisa Kennedy | Peer Specialist | 132 Ne B St # 24, Grants Pass, OR 97526-2114 | 2020-02-13 |
1730711953 | Michael Anthony Duran | Peer Specialist | 1515 Hill St Se, Albany, OR 97322-6715 | 2020-02-05 |
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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.