Kristen Ann Desilets

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

THW000108865 Issued in OR

Practice address

1200 Hilyard St Ste 450
Eugene, OR 97401-8164

Phone

(458) 205-7131

Fax

(458) 205-7061

NPI assigned

Mar 31, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Peacehealth Medical Group

  • Family Medicine Physician
  • Eugene, OR
  • NPI 1447207287

  Counselor

  NPD (past)

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

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1124768593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 453",
            "city": "HINES",
            "state": "OR",
            "postal_code": "977380453",
            "telephone_number": "541-413-0483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 HILYARD ST STE 450",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974018164",
            "telephone_number": "458-205-7131",
            "fax_number": "458-205-7061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Hilyard St Ste 150",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974018138",
            "country_code": "US",
            "telephone_number": "458-205-6074",
            "fax_number": "541-687-6154",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "120 S Roanoke Ave",
            "address_purpose": "LOCATION",
            "city": "Hines",
            "state": "OR",
            "postal_code": "977382576",
            "country_code": "US",
            "telephone_number": "541-573-1780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESILETS",
        "first_name": "KRISTEN",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-31",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "THW000108865",
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "THW000108865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Cristina Derby, L.AC.
• Derek James Bevans DMD
• Melissa Derhak, LPN
• Brock Anthony Derrick
• Noora Derrington-Via, LMT
• Richard Earl Desmond Jr., M.S. QMHP
• Susan Holmes Desmond, CCC-SLP
• Robin Anne Detmer, PT
• Mark Detweiler, M.S., CCC-SLP
• Alice B Deutsch, D.M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; 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.