Individual provider Active NPI

Trevor Harrison Church, CRM

  • Case Manager/Care Coordinator
  • Saint Helens, OR
National Provider Identifier
1962140632
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
58147 Columbia River Hwy Ste C
Saint Helens, OR 97051-6229
Phone
(503) 396-5322
NPI assigned
May 23, 2022
Last updated
May 23, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

58147 Columbia River Hwy Ste C
Saint Helens, OR 97051-6229

Mailing address

58147 Columbia River Hwy
Saint Helens, OR 97051-6229

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

NPI Registry JSON

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

{
    "created_epoch": "1653264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1962140632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58147 COLUMBIA RIVER HWY",
            "city": "SAINT HELENS",
            "state": "OR",
            "postal_code": "970516229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58147 COLUMBIA RIVER HWY STE C",
            "city": "SAINT HELENS",
            "state": "OR",
            "postal_code": "970516229",
            "telephone_number": "503-396-5322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCH",
        "first_name": "TREVOR",
        "middle_name": "HARRISON",
        "credential": "CRM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-23",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Helens, OR

Sources for this page

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