Kimberly Brent

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

500 SE Cass Ave
Roseburg, OR 97470-3103

Phone

(541) 839-1345

Fax

(855) 670-1791

NPI assigned

Jun 30, 2020

Last updated

Sep 9, 2024By 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

Medicare fee-for-service enrollment

Enrolled in TX

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

Mental Health Counselor

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cow Creek Band of Umpqua Tribe of IndiansGroup PAC ID 8921099474, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Cow Creek Band of Umpqua Tribe of Indians

  dba Cow Creek Health & Wellness Ctr

  • Federally Qualified Health Center (FQHC)
  • Roseburg, OR
  • NPI 1063502714

  TX

  Medicare reassignment Care Compare group NPD
• Cow Creek Band of Umpqua Tribe of Indians

  dba Cow Creek Health & Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Canyonville, OR
  • NPI 1134567993
  NPD (past)

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

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1649897281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SE CASS AVE",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974703103",
            "telephone_number": "541-838-1345",
            "fax_number": "541-670-1791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SE CASS AVE",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974703103",
            "telephone_number": "541-839-1345",
            "fax_number": "855-670-1791"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "548 SE Jackson St",
            "address_purpose": "LOCATION",
            "city": "Roseburg",
            "state": "OR",
            "postal_code": "974704983",
            "country_code": "US",
            "telephone_number": "541-440-3532",
            "fax_number": "541-440-3554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRENT",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-30",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea S. Braun, DDS
• Katherine Weber Braunlich, D.O
• Phillip Robert Braunlich, D.O.
• Marshall Brayton
• Chasteen Renee Brazil
• Kathleen F. Brewer
• Brian E. Hayes, M.D., P.C.
• Matthew Bricka, RRT
• Kurt A Brickner, DO
• Bridge Health Collective LLC

• Mental Health Counselor in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.