Kisty Ann Baty, CRM
Individual provider Active NPI Peer Specialist · Prineville, OR
NPI 1285225664 · NPPES record last updated Jan 28, 2021
Key facts
- NPI
- 1285225664
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- License
- 21-CRM-331 (OR)
- Practice address
- 357 NE Court St
Prineville, OR 97754-1936 - Phone
- (541) 504-7535
- Fax
- (541) 504-7535
- NPI assigned
- Jan 28, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21-CRM-331 | OR | MD | Peer Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Choices Recovery Services, LLC | Peer Specialist | Current |
Accepting new patients |
Locations
357 NE CT St
Prineville, OR 97754
Phone (541) 504-7535
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | 21-CRM-331 | OR | Yes |
Addresses
Primary practice location
357 NE Court St
Prineville, OR 97754-1936
Mailing address
PO Box 2298
Prineville, OR 97754-0470
Phone (541) 504-7535
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 21-CRM-331 | Other | OR | CRM CERTIFICATION NUMBER |
Other providers in Prineville, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 28, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.