Individual provider Active NPI

Brianne Brinkley

  • Peer Specialist
  • Portland, OR
National Provider Identifier
1124690045
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
21-CRM-735 Issued in OR
Practice address
2236 SE Belmont St
Portland, OR 97214-2817
Phone
(503) 445-7699
Fax
(503) 802-0199
NPI assigned
Jul 12, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X T-22-1773 OR
Case Manager/Care Coordinator 171M00000X OR
Peer Specialist 175T00000X 21-CRM-735 OR Primary

Addresses

Primary practice location

2236 SE Belmont St
Portland, OR 97214-2817

Mailing address

3224 SE 120TH Ave
Portland, OR 97266-1657
Phone (503) 851-7518

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
T-22-1773ORMDAddiction (Substance Use Disorder) Counselor
21-CRM-735ORMDPeer Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Cascade AIDS Project PastSince Jul 31, 2023 Accepting new patients
Cascade AIDS Project PastSince Jul 31, 2023 Accepting new patients

Organizations & group practices 2

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": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1124690045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3224 SE 120TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972661657",
            "telephone_number": "503-851-7518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2236 SE BELMONT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142817",
            "telephone_number": "503-445-7699",
            "fax_number": "503-802-0199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINKLEY",
        "first_name": "BRIANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-12",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "T-22-1773",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "21-CRM-735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.