Kelli Gentry Wright, MS

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L6031 Issued in OR

Practice address

3425 13TH St
Baker City, OR 97814-1340

Phone

(541) 523-7400

Fax

(541) 523-4927

NPI assigned

Apr 29, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

New Directions Northwest IncGroup PAC ID 0446572721, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• New Directions Northwest, Inc

  • Community/Behavioral Health Agency
  • Baker City, OR
  • NPI 1235124462
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1240963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1407090822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 13TH ST",
            "city": "BAKER CITY",
            "state": "OR",
            "postal_code": "978141340",
            "telephone_number": "541-523-7400",
            "fax_number": "541-523-4927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 13TH ST",
            "city": "BAKER CITY",
            "state": "OR",
            "postal_code": "978141340",
            "telephone_number": "541-523-7400",
            "fax_number": "541-523-4927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "KELLI",
        "middle_name": "GENTRY",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-29",
        "last_updated": "2024-08-30",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "T-23-3419",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L6031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014274",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "4490398",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500699801",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Gordon Wilson, L.D.
• Laurie J Wittich
• Brenon Witty
• Julie Veeann Witty
• Heather Kissane Wood, L.C.S.W.
• Diane Eileen Wroe
• Carol Lee Young
• Sherry Melena Zacharias Forsyth, CADC II, CGAC II
• Alicia Lee Zahn
• Derek Guy Zickgraf, DO

• Clinical Social Worker in Baker City, OR
• Providers in Baker City, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.