TIMOTHY KELLY (NPI# 1518590629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518590629 |
| Entity Type | Individual |
| Full Name | TIMOTHY KELLY |
| Practice Address |
14600 Nw Cornell Rd Portland OR 97229-5442 |
| Practice Telephone | 5036453581 |
| Mailing Telephone | 5036453581 |
| Enumeration Date | 2020-02-17 |
| Last Update Date | 2020-02-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720561608 | Timothy Kelly | Social Worker | 25a Vreeland Rd, Florham Park, NJ 07932-1910 | 2018-09-07 |
| 1942525928 | Timothy Anton Kelly | Home Health | 7954 Brooklyn Boulavard, 7954, Brooklyn Park, MN 55445 | 2010-04-01 |
| 1003026261 | Timothy Richard Kelly | Psychiatry & Neurology | 510 Azalea Dr Ste 200, Oxford, MS 38655-6903 | 2007-05-23 |
| 1700953163 | Timothy James Kelly | Chiropractor | 1038 Washington Street, Fairfield, CA 94533-5545 | 2006-11-29 |
| 1063592558 | Timothy P Kelly | Chiropractor | 3098 Piedmont Rd Ne Ste 430, Atlanta, GA 30305-2600 | 2006-10-17 |
| 1588653281 | Timothy Lynn Kelly | Dentist | 1600 Mountain View Rd, Suite 104, Rapid City, SD 57702-4381 | 2005-10-17 |
| 1992798169 | Timothy L Kelly | Anesthesiology | 831 Nw Council Dr, Suite 300, Gresham, OR 97030-3721 | 2005-08-23 |
| 1497758825 | Timothy G Kelly | Ophthalmology | 1915 Tradd Ct, Wilmington, NC 28401-6638 | 2005-05-31 |
| 1073140497 | Timothy Stephen Kelly | Student in an Organized Health Care Education/Training Program | 1 Gustave L Levy Pl # 1149, New York, NY 10029-6504 | 2020-03-25 |
| 1649805888 | Timothy Dwyer Kelly | Student in an Organized Health Care Education/Training Program | 13001 E 17th Pl, Aurora, CO 80045-2570 | 2020-03-09 |
| Street Address |
14600 NW CORNELL RD |
| City | PORTLAND |
| State | OR |
| Zip Code | 97229-5442 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467408013 | Lifeworks Nw | Counselor | 14600 Nw Cornell Rd, Portland, OR 97229-5442 | 2006-05-25 |
| 1083213771 | Rebecca Saunders | Counselor | 14600 Nw Cornell Rd, Portland, OR 97229-5442 | 2020-10-22 |
| 1225637986 | Nicholas David Carter | Student in an Organized Health Care Education/Training Program | 14600 Nw Cornell Rd, Portland, OR 97229-5442 | 2020-10-22 |
| 1720686223 | Ruby Benner | Case Manager/Care Coordinator | 14600 Nw Cornell Rd, Portland, OR 97229-5442 | 2020-10-15 |
| 1326654898 | Lindsy Jean Brownson | Student in an Organized Health Care Education/Training Program | 14600 Nw Cornell Rd, Portland, OR 97229-5442 | 2020-09-21 |
| 1689280554 | Elizabeth Cady Yu Louise Handley | Student in an Organized Health Care Education/Training Program | 14600 Nw Cornell Rd, Portland, OR 97229-5442 | 2020-09-16 |
| 1184238024 | Clark Hazel | Counselor | 14600 Nw Cornell Rd, Portland, OR 97229-5442 | 2020-09-08 |
| 1942813704 | Juliana Marler | Student in an Organized Health Care Education/Training Program | 14600 Nw Cornell Rd, Portland, OR 97229-5442 | 2020-08-30 |
| 1508479478 | Kevin I Lay | Case Manager/Care Coordinator | 14600 Nw Cornell Rd, Portland, OR 97229-5442 | 2020-08-28 |
| 1144833674 | Alyssa Pataki | Student in an Organized Health Care Education/Training Program | 14600 Nw Cornell Rd, Portland, OR 97229-5442 | 2020-08-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851919906 | Anjana Rajan | Counselor | Lifeworks Northwest, 14600 Nw Cornell Rd, Portland, OR 97229 | 2020-07-06 |
| 1871138453 | Kedrick Starr | Case Manager/Care Coordinator | 14600 Nw Cornell Rd., Portland, OR 97229 | 2019-11-07 |
| 1477102689 | Raquel A Bishop | Nurse Practitioner | 12400 Nw Cornell Rd Ste 100, Portland, OR 97229 | 2019-09-10 |
| 1669026134 | Alexandra Elizabeth Lodwig | Speech-Language Pathologist | 255 Nw Lost Springs Terrace Apt 304, Portland, OR 97229 | 2019-08-01 |
| 1003316043 | Jenny Lavonne Thom | Counselor | 15220 Nw Laidlaw Rd., Suite 280, Portland, OR 97229 | 2018-02-16 |
| 1194230664 | Ankita Guchait | Case Manager/Care Coordinator | 14600 Nw Cornell Rd, Portland, OR 97229 | 2017-12-06 |
| 1568988913 | Hannah Hendrix Klingelheber | Speech-Language Pathologist | 15605 Nw Ryegrass St., Portland, OR 97229 | 2017-08-17 |
| 1548791213 | Adeline Mitchell | Registered Nurse | 14600 Sw Cornell Rd., Portland, OR 97229 | 2017-03-24 |
| 1538610670 | Crystal Graves | Peer Specialist | 14600 Nw Cornell, Portland, OR 97229 | 2016-10-24 |
| 1639533185 | Evelin James | Dental Hygienist | 5879 Nw Lark Meadow Ter, Portland, OR 97229 | 2016-04-11 |
| Find all providers in zip 97229 | ||||
| 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 |
|---|---|---|---|---|
| 1487255576 | Thomas Roy Hooks | Peer Specialist | 1221 Sw 11th Ave Apt 102, Portland, OR 97205-2143 | 2020-11-04 |
| 1538773155 | Mamie Nzigire Zagabe | Peer Specialist | 605 Se Cesar Estrada Chavez Blvd, Portland, OR 97214 | 2020-09-01 |
| 1245896307 | Anthony James Hardy | Peer Specialist | 10336 Ne Wygant St, Portland, OR 97220-3368 | 2019-05-14 |
| 1881155596 | Laray Jermaine Thomas | Peer Specialist | 11509 Se Stephens St, Portland, OR 97216-3660 | 2019-03-26 |
| 1932684248 | Dorothy Joanna Burton | Peer Specialist | 3716 Ne Martin Luther King Blvd, Portland, OR 97212-1111 | 2018-10-02 |
| 1750886255 | Steven Wade | Peer Specialist | 4512 Ne Portland Hwy, Portland, OR 97218-1363 | 2018-03-27 |
| 1669991212 | Kimberly Jaye Randall | Peer Specialist | 17214 Se Division St Ste 2, Portland, OR 97236-1282 | 2017-09-14 |
| 1689103897 | Walter Bulter | Peer Specialist | 5257 Ne Martin Luther King Jr Blvd Ste 202, Portland, OR 97211-3283 | 2017-06-09 |
| 1306373543 | Brenda Kay Mitchell | Peer Specialist | 10373 Ne Hancock St Ste 132, Portland, OR 97220-3873 | 2017-05-18 |
| 1760914493 | Changing Perceptions | Peer Specialist | 1720 Nw Lovejoy St # 329, Portland, OR 97209-2346 | 2017-03-31 |
| Find all providers in PORTLAND | ||||
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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.