Cody M Cimmiyotti

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

THW000108876 Issued in OR

Practice address

46314 Timine Way
Pendleton, OR 97801-9417

Phone

(541) 966-9830

NPI assigned

May 9, 2023

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1003506429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978010160",
            "telephone_number": "541-966-9830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46314 TIMINE WAY",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978019417",
            "telephone_number": "541-966-9830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIMMIYOTTI",
        "first_name": "CODY",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-09",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "THW000108876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON",
            "identifier": "THW000108876",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kateara C Chavez, CRM
• CHI National Home Care
• CHI National Home Care
• Chris Humphreys LLC
• Shannon Diane Chrisman, CSWA
• City of Pendleton
• Jessica Clark
• Katie A Clark
• Robert Marc Clark, LCSW LICENSED CLINIC
• Timothy John Clark

• Peer Specialist in Pendleton, OR
• Providers in Pendleton, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.