Individual provider Active NPI

Josh Lair, CRM

  • Peer Specialist
  • Salem, OR
National Provider Identifier
1225487127
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
863 Liberty St NE
Salem, OR 97301-2451
Phone
(503) 399-5597
Fax
(503) 316-9740
NPI assigned
Jun 10, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X OR Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 16-CRM-070 OR

Addresses

Primary practice location

863 Liberty St NE
Salem, OR 97301-2451

Mailing address

3321 Harold Dr NE
Salem, OR 97305-1339
Phone (503) 399-5597

Other identifiers 1

IdentifierTypeStateIssuer
263634042MedicaidOR

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
16-CRM-070ORMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1465516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1225487127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3321 HAROLD DR NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051339",
            "telephone_number": "503-399-5597",
            "fax_number": "503-316-9740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "863 LIBERTY ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012451",
            "telephone_number": "503-399-5597",
            "fax_number": "503-316-9740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAIR",
        "first_name": "JOSH",
        "credential": "CRM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-10",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "16-CRM-070",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263634042",
            "state": "OR"
        }
    ],
    "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 Dec 18, 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.