Kevin M Wentzel, CRM

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

21-CRM-442 Issued in OR

Practice address

125 SW C St
Madras, OR 97741-1458

Phone

(541) 777-7847

Fax

(541) 512-7090

NPI assigned

Apr 6, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Turning Points Recovery Services Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Prineville, OR
  • NPI 1225546773
  NPD

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1346829454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "389 SW SCALEHOUSE CT STE 130",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023241",
            "telephone_number": "541-777-7847",
            "fax_number": "541-512-7090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 SW C ST",
            "city": "MADRAS",
            "state": "OR",
            "postal_code": "977411458",
            "telephone_number": "541-777-7847",
            "fax_number": "541-512-7090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENTZEL",
        "first_name": "KEVIN",
        "middle_name": "M",
        "credential": "CRM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-06",
        "last_updated": "2021-04-06",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "21-CRM-442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHACBO",
            "identifier": "21-CRM-442",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashmabett Vera-Gonzalez, CADC
• Nicholas C Vergotis
• Angela Vetterick, PA C
• Paula M Watson, LPC
• Kaycee Weeks
• Dylan Ray Williams
• Kip Worley
• Gary E Wright, CADC II
• Marina Yancey, CRM
• Jasmyn Kianna Zachery, PHARM.D., RPH

• Peer Specialist in Madras, OR
• Providers in Madras, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; 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.