Individual provider Active NPI

Christina E Higgins Korkow

  • Peer Specialist
  • Salem, OR
National Provider Identifier
1104331370
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
THW2253 Issued in OR
Practice address
2555 Silverton Rd NE
Salem, OR 97301-0837
Phone
(503) 393-4273
NPI assigned
Dec 8, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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 THW2253 OR Primary

Addresses

Primary practice location

2555 Silverton Rd NE
Salem, OR 97301-0837

Mailing address

614 W Central St
Gates, OR 97346-9307
Phone (503) 409-1506

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
THW2253ORMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1512691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1104331370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 W CENTRAL ST",
            "city": "GATES",
            "state": "OR",
            "postal_code": "973469307",
            "telephone_number": "503-409-1506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 SILVERTON RD NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973010837",
            "telephone_number": "503-393-4273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGGINS KORKOW",
        "first_name": "CHRISTINA",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-08",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "THW2253",
            "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 Mar 14, 2022; 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.