Individual provider Active NPI

Chelan Fern Thissell-Armstrong, CRM

  • Peer Specialist
  • Burns, OR
National Provider Identifier
1750074472
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
23-CRM-2005 Issued in OR
Practice address
348 W Adams St
Burns, OR 97720-1710
Phone
(541) 573-8376
Fax
(541) 573-8378
NPI assigned
May 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X 23-CRM-2005 OR Primary

Addresses

Primary practice location

348 W Adams St
Burns, OR 97720-1710

Mailing address

348 W Adams St
Burns, OR 97720-1710
Phone (541) 573-8376

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
23-CRM-2005ORMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1685404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1750074472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 W ADAMS ST",
            "city": "BURNS",
            "state": "OR",
            "postal_code": "977201710",
            "telephone_number": "541-573-8376",
            "fax_number": "541-573-8378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 W ADAMS ST",
            "city": "BURNS",
            "state": "OR",
            "postal_code": "977201710",
            "telephone_number": "541-573-8376",
            "fax_number": "541-573-8378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THISSELL-ARMSTRONG",
        "first_name": "CHELAN",
        "middle_name": "FERN",
        "credential": "CRM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-30",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "23-CRM-2005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burns, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; 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.