Individual provider Active NPI

Jason Kibbey Cripe

  • Peer Specialist
  • Corvallis, OR
National Provider Identifier
1346062536
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
23-CRM-2353 Issued in OR
Practice address
456 SW Monroe Ave Suite 108
Corvallis, OR 97333
Phone
(541) 791-3411
NPI assigned
Oct 29, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 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 23-CRM-2353 OR Primary

Addresses

Primary practice location

456 SW Monroe Ave Suite 108
Corvallis, OR 97333

Mailing address

1604 Marion St SE
Albany, OR 97322
Phone (541) 981-8859

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
23-CRM-2353ORMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1730160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1346062536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 MARION ST SE",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "97322",
            "telephone_number": "541-981-8859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 SW MONROE AVE SUITE 108",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "97333",
            "telephone_number": "541-791-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIPE",
        "first_name": "JASON",
        "middle_name": "KIBBEY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-29",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "23-CRM-2353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.