Individual provider Active NPI

Rachel Overall

  • Peer Specialist
  • Salem, OR
National Provider Identifier
1093488165
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
21-CRM-464 Issued in OR
Practice address
3321 Harold Dr NE
Salem, OR 97305-1339
Phone
(503) 363-2021
NPI assigned
Jul 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X 21-CRM-464 OR Primary

Addresses

Primary practice location

3321 Harold Dr NE
Salem, OR 97305-1339

Mailing address

250 Church St SE Ste 202
Salem, OR 97301-3921
Phone (503) 363-2021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
21-CRM-464ORMDPeer Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Bridgeway Recovery Services CurrentSince Apr 13, 2025 Accepting new patients

Locations

3321 Harold Dr NE
Salem, OR 97305
Phone (503) 399-5597

250 Church St SE
Ste 202
Salem, OR 97301

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/bridgewayrecovery/r4/

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1627257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1093488165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 CHURCH ST SE STE 202",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013921",
            "telephone_number": "503-363-2021",
            "fax_number": "503-689-1587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3321 HAROLD DR NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051339",
            "telephone_number": "503-363-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERALL",
        "first_name": "RACHEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-26",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "21-CRM-464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; 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.