Roxanne Franklin Wilson, BA, QMHA, PSS

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

THW2008 Issued in OR

Practice address

1900 NE Highway 99W Ste K
McMinnville, OR 97128-2757

Phone

(503) 472-4511

Fax

(503) 714-6306

NPI assigned

Oct 30, 2019

Last updated

Mar 28, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fifth Corner Academy

  dba Fifth Corner Community Services

  • Child & Adolescent Psychiatry Physician
  • McMinnville, OR
  • NPI 1033753231

  Nutrition, Education

  NPD Authorized official

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

{
    "created_epoch": "1572393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585353600000",
    "number": "1427692623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 NE 2ND ST UNIT 133",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971284762",
            "telephone_number": "503-472-4511",
            "fax_number": "503-714-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 NE HIGHWAY 99W STE K",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971282757",
            "telephone_number": "503-472-4511",
            "fax_number": "503-714-6306"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 NE Highway 99W Ste M",
            "address_purpose": "LOCATION",
            "city": "McMinnville",
            "state": "OR",
            "postal_code": "971282757",
            "country_code": "US",
            "telephone_number": "503-714-6306",
            "fax_number": "503-714-6306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ROXANNE",
        "middle_name": "FRANKLIN",
        "name_prefix": "Mrs.",
        "credential": "BA, QMHA, PSS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-30",
        "last_updated": "2020-03-28",
        "certification_date": "2020-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1744R1102X",
            "taxonomy_group": "",
            "desc": "Specialist, Research Study",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OR",
            "license": "THW2008",
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "THW2008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHA THW REGISTRY NUMBER",
            "identifier": "THW2008",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Bruce Williams, MD
• Waverly Tyrese Williams
• Theodore J Williamson, M.D.
• Carmen Dolores Wilson
• Jason Edward Wilson
• Kayla Renae Winkler, MOT
• J'Deanna Winn, MA
• Nicole Patrice Winnen, R.PH.
• Arri Corvaine Winter
• Molly Winterrowd

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2020; 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.