Theresa Keys, CRM, PWS

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

21-CRM-705 Issued in OR

Practice address

1741 Newmark Ave
Coos Bay, OR 97420-4704

Phone

(541) 622-0066

NPI assigned

Sep 12, 2022

Last updated

Sep 12, 2022By 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 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1508588112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 S EMPIRE BLVD",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974203374",
            "telephone_number": "541-622-0066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1741 NEWMARK AVE",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974204704",
            "telephone_number": "541-622-0066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEYS",
        "first_name": "THERESA",
        "credential": "CRM, PWS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-12",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "21-CRM-705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEER WELLNESS SPECIALIST ADULT ADDICTIONS/ADULT MENTAL HEALTH",
            "identifier": "THW000106053",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEER SUPPORT SPECIALIST ADULT ADDICTIONS",
            "identifier": "THW000106053",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Keen
• Madisyn Elizabeth Keller, DPT
• Ian Seward Kennington
• Laura K. Kent, FNP
• Walter F Kerwin, M.D.
• Donna Chere Kifer
• Bambi King
• William Drawdy King, MD
• Emma Kinross
• Deborah K Kirby

• Peer Specialist in Coos Bay, OR
• Providers in Coos Bay, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; 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.