AMY NICOLE COZAD (NPI# 1922505767) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922505767 |
| Entity Type | Individual |
| Full Name | AMY NICOLE COZAD |
| Practice Address |
4275 Commercial St Se Ste 180 Salem OR 97302-4087 |
| Practice Telephone | 5033903161 |
| Practice Fax Number | 5033903161 |
| Mailing Telephone | 5033638068 |
| Mailing Fax Number | 5033903161 |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2018-04-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
4275 COMMERCIAL ST SE STE 180 |
| City | SALEM |
| State | OR |
| Zip Code | 97302-4087 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043820905 | Amy Bliss | Peer Specialist | 4275 Commercial St Se Ste 180, Salem, OR 97302-4087 | 2020-08-05 |
| 1871129502 | Jonathan L Roeder | Peer Specialist | 4275 Commercial St Se Ste 180, Salem, OR 97302-4087 | 2020-03-13 |
| 1316580822 | Angela Weirich | Peer Specialist | 4275 Commercial St Se Ste 180, Salem, OR 97302-4087 | 2019-10-28 |
| 1730741521 | Signe Louise Miller | Case Manager/Care Coordinator | 4275 Commercial St Se Ste 180, Salem, OR 97302-4087 | 2019-07-02 |
| 1063971216 | Laurie A Erickson | Peer Specialist | 4275 Commercial St Se Ste 180, Salem, OR 97302-4087 | 2019-03-18 |
| 1972068989 | Susana Pelayo | Peer Specialist | 4275 Commercial St Se Ste 180, Salem, OR 97302-4087 | 2019-02-04 |
| 1578060398 | Vanessa Solorio | Peer Specialist | 4275 Commercial St Se Ste 180, Salem, OR 97302-4087 | 2018-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952954679 | Eric Anthony Bohm | Pharmacist | 2757 22nd St. Se, Salem, OR 97302 | 2019-07-22 |
| 1598223737 | Michael Robert Martini | Counselor | 960 Liberty Rd Se Suite 120, Salem, OR 97302 | 2019-03-06 |
| 1659857480 | Avalina Pharmacy Inc | Pharmacy | 3507 Commercial St Se, Salem, OR 97302 | 2018-07-16 |
| 1649762733 | Joseph Bochsler | Physical Therapist | 3220 Liberty Rd. S., Salem, OR 97302 | 2018-06-04 |
| 1922533652 | Brianne Elizabeth Sischo | Licensed Practical Nurse | 3871 Fairview Industrial Dr. Se Ste, 150, Salem, OR 97302 | 2017-05-01 |
| 1851825566 | Modern Nose Clinic LLC | Otolaryngology | 340 Vista Ave Se, Ste 100, Salem, OR 97302 | 2017-04-19 |
| 1720529803 | Nicholas Forsberg | Massage Therapist | 126 Mize Rd S, Salem, OR 97302 | 2017-03-09 |
| 1437691078 | Kimo Mahi | Specialist/Technologist, Other | 2373 Kuebler Rd. S, Salem, OR 97302 | 2016-11-14 |
| 1588113278 | New Life Family Medicine LLC | Clinic/Center | 842 Commercial Street Ne, Salem, OR 97302 | 2016-09-23 |
| 1073060117 | Susan Morag Robnett | Counselor | 912 Fir Street South, Salem, OR 97302 | 2016-09-07 |
| Find all providers in zip 97302 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528677820 | Charice Monette | Peer Specialist | 4151 Kacey Cir Ne, Salem, OR 97305-4504 | 2020-07-23 |
| 1821649336 | Christopher Adam Handy | Peer Specialist | 3050 Park Ave Ne, Salem, OR 97301-8615 | 2019-09-25 |
| 1649785817 | Keileigh Joy Dull | Peer Specialist | 3213 Center St Ne, Salem, OR 97301-4666 | 2017-12-08 |
| 1104331370 | Christina E Higgins Korkow | Peer Specialist | 2555 Silverton Rd Ne, Salem, OR 97301-0837 | 2017-12-08 |
| 1437682044 | Debra Janae Rice | Peer Specialist | 2555 Silverton Rd Ne Ste C, Salem, OR 97301-0837 | 2017-04-10 |
| 1952834194 | Brian Smith | Peer Specialist | 769 Hawthorne Ave Ne, Salem, OR 97301-4623 | 2017-04-05 |
| 1588013577 | Sarah Harris | Peer Specialist | 4255 32nd Pl Ne, Salem, OR 97301-6735 | 2016-06-09 |
| 1194187476 | Tammi Paul | Peer Specialist | 1300 Broadway St Ne Ste 403, Salem, OR 97301-1420 | 2016-03-24 |
| 1710343926 | Teresa Anne Sims | Peer Specialist | 1599 State Street Ne, Salem, OR 97301 | 2016-01-05 |
| 1588029292 | Lisa Orellana | Peer Specialist | 4915 Swegle Rd Ne Unit 46, Salem, OR 97301-2153 | 2015-12-22 |
| Find all providers in SALEM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.