Cole Douglas Carter, CRM

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

24-CRM-3799 Issued in OR

Practice address

500 SE Cass Ave Ste 110
Roseburg, OR 97470-3165

Phone

(541) 677-5520

Fax

(855) 670-1788

NPI assigned

Apr 2, 2025

Last updated

Apr 2, 2025By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Cow Creek Band of Umpqua Tribe of Indians

  dba Cow Creek Health & Wellness Ctr

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

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

{
    "created_epoch": "1743552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1932903614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2589 NW EDENBOWER BLVD",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974716224",
            "telephone_number": "541-672-8533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SE CASS AVE STE 110",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974703165",
            "telephone_number": "541-677-5520",
            "fax_number": "855-670-1788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "COLE",
        "middle_name": "DOUGLAS",
        "credential": "CRM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-02",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "24-CRM-3799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Carr
• Catrina C Carroll, RN
• Vicki Lynn Carroll
• Brandi Carson, CHW
• Chalene Dawn Carson, RDH
• Leesa Carter
• Cascade Optometry,Inc (Cascade Optometry)
• Casey Kohl LCSW LLC Dba Mid-Valley Mindfulness
• Deborah Caskey
• Erin P Cassidy, FNP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; 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.