Active NPI
Cheryl Marlene Rosecrans, CHW
- Community Health Worker
- Salem, OR
National Provider Identifier
1215659610
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- THW000107234
- Practice address
- 610 Hawthorne Ave SE Ste 200
Salem, OR 97301-5378 - Phone
- (503) 302-0104
- Fax
- (503) 581-0043
- NPI assigned
- Sep 13, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | THW000107234 | OR | Primary |
Addresses
Primary practice location
610 Hawthorne Ave SE Ste 200
Salem, OR 97301-5378
Mailing address
610 Hawthorne Ave SE Ste 200
Salem, OR 97301-5378
Phone (503) 302-0104
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
| License | State | Type | Specialty |
|---|---|---|---|
| THW000107234 | OR | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663027200000",
"number": "1215659610",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 HAWTHORNE AVE SE STE 200",
"city": "SALEM",
"state": "OR",
"postal_code": "973015378",
"telephone_number": "503-302-0104",
"fax_number": "503-581-0043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 HAWTHORNE AVE SE STE 200",
"city": "SALEM",
"state": "OR",
"postal_code": "973015378",
"telephone_number": "503-302-0104",
"fax_number": "503-581-0043"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSECRANS",
"first_name": "CHERYL",
"middle_name": "MARLENE",
"credential": "CHW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-13",
"last_updated": "2022-09-13",
"certification_date": "2022-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "OR",
"license": "THW000107234",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
- Kyrai Ivy Ann Rose, PH.D.
- Renske Elvira Rose, MPT
- Roseanne Pikul, LMFT, LLC
- Glen Stanley Roseborough, MD
- Roseburg Assisted Living LLC (Oak Park Assisted Living Community)
- Rosemont Retirement & Assisted Living Community LLC (Rosemont Retirement & Assisted Living Community)
- Philip A. Rosen, MD
- Billie Jean Rosenblad, LPC
- Erika Marcia Rosin, BSN, RN
- Cameron John Ross
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.