Active NPI
Terry Goldsworthy, PEER SUPPORT
- Peer Specialist
- Roseburg, OR
National Provider Identifier
1376996140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 1600 NW Garden Valley Blvd
Suite 110
Roseburg, OR 97471-8700 - Phone
- (541) 440-3532
- NPI assigned
- Jul 18, 2016
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Primary |
Addresses
Primary practice location
1600 NW Garden Valley Blvd
Suite 110
Roseburg, OR 97471-8700
Mailing address
1600 NW Garden Valley Blvd
Suite 110
Roseburg, OR 97471-8700
Phone (541) 440-3532
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Health Alliance | Past | Accepting new patients | |
| Community Health Alliance | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Sutherlin, OR
- NPI 1396113122
-
- Community/Behavioral Health Agency
- Roseburg, OR
- NPI 1871947986
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468800000000",
"number": "1376996140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 NW GARDEN VALLEY BLVD",
"address_2": "SUITE 110",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "974718700",
"telephone_number": "541-440-3532"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 NW GARDEN VALLEY BLVD",
"address_2": "SUITE 110",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "974718700",
"telephone_number": "541-440-3532"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDSWORTHY",
"first_name": "TERRY",
"credential": "PEER SUPPORT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-18",
"last_updated": "2016-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseburg, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.