Matthew Smith, QMHA- PEER SUPPORT

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

1345 Birch Ave
Cottage Grove, OR 97424-1416

Phone

(541) 942-3939

NPI assigned

May 25, 2016

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• South Lane Mental Health Services, Inc

  • Community/Behavioral Health Agency
  • Cottage Grove, OR
  • NPI 1306905831
  NPD (past)

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

{
    "created_epoch": "1464134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464825600000",
    "number": "1386092856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5",
            "city": "COTTAGE GROVE",
            "state": "OR",
            "postal_code": "974240001",
            "telephone_number": "541-942-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 BIRCH AVE",
            "city": "COTTAGE GROVE",
            "state": "OR",
            "postal_code": "974241416",
            "telephone_number": "541-942-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MATTHEW",
        "credential": "QMHA- PEER SUPPORT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-25",
        "last_updated": "2016-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Simard Chiropractic, PC
• Annette Marie Simard, D.C.
• Deirdre Simpson-Rhoads, LCSW
• Elizabeth Gaylyn Smith, MFT
• Jodi Smith, QMHA
• Suzanne M. Snellen, GNP
• Sol Transit Assisted Oregon Corp
• Jose Arnulfo Solis, D.O.
• Noeul Song
• South Lane Children'S Dental Clinic

• Community Health Worker in Cottage Grove, OR
• Providers in Cottage Grove, OR by specialty
• Community Health Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.

Verify at the official NPI Registry.