Individual provider Active NPI

Jerri L Kerr, CRM

  • Peer Specialist
  • Portland, OR
National Provider Identifier
1184467441
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
24-CRM-3018 Issued in OR
Practice address
12612 SE Stark St BLDG M
Portland, OR 97233-1058
Phone
(503) 906-9995
NPI assigned
Jun 14, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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 24-CRM-3018 OR Primary

Addresses

Primary practice location

12612 SE Stark St BLDG M
Portland, OR 97233-1058

Mailing address

12540 SW Main St Ste 202
Tigard, OR 97223-6198
Phone (503) 906-9995

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
24-CRM-3018ORMDPeer Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Recovery Works NW LLC CurrentSince Jun 16, 2024 Accepting new patients
Recovery Works NW LLC CurrentSince Jun 16, 2024 Accepting new patients

Locations

12612 SE Stark St
Bldg M
Portland, OR 97233
Phone (503) 906-9995

12540 SW Main St
Ste 202
Tigard, OR 97223
Phone (503) 906-9995

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": "1718323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1184467441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12540 SW MAIN ST STE 202",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236198",
            "telephone_number": "503-906-9995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12612 SE STARK ST BLDG M",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331058",
            "telephone_number": "503-906-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERR",
        "first_name": "JERRI",
        "middle_name": "L",
        "credential": "CRM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-14",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "24-CRM-3018",
            "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 Jun 14, 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.