Individual provider Active NPI

Amy Gean Garrett, CHW

  • Community Health Worker
  • Siletz, OR
National Provider Identifier
1730643883
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
THW000003355 Issued in OR
Practice address
200 Gwee Shut Rd
Siletz, OR 97380-2036
Phone
(541) 444-1030
Fax
(541) 444-9678
NPI assigned
Jan 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X THW000003355 OR Primary

Addresses

Primary practice location

200 Gwee Shut Rd
Siletz, OR 97380-2036

Mailing address

PO Box 320
Siletz, OR 97380-0320
Phone (541) 444-1030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
THW000003355ORMDCommunity Health Worker

NPI Registry JSON

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

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1730643883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 320",
            "city": "SILETZ",
            "state": "OR",
            "postal_code": "973800320",
            "telephone_number": "541-444-1030",
            "fax_number": "541-444-9678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GWEE SHUT RD",
            "city": "SILETZ",
            "state": "OR",
            "postal_code": "973802036",
            "telephone_number": "541-444-1030",
            "fax_number": "541-444-9678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRETT",
        "first_name": "AMY",
        "middle_name": "GEAN",
        "name_prefix": "Ms.",
        "credential": "CHW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-23",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "OR",
            "license": "THW000003355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Siletz, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; 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.