Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1396201216 Individual Practitioner Male Practitioner

Anthony L Wilson , CRM

Peer Specialist • Coos Bay, OR

Professional Overview & Biography Verified Profile Summary

Anthony Wilson, CRM is a registered healthcare professional specializing in Peer Specialist in Coos Bay, OR. Practice services are available at 155 S EMPIRE BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

155 S Empire Blvd

Coos Bay, OR 974203374

Telephone 5412564686
Associated Practice Facility / Clinic
🏢 Bay Area First Step, Inc. Facility NPI 1871970897

Specialty Benchmarks & Practice Insights

Comparative analytics for Peer Specialist in Coos Bay, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
52 Specialists

Practicing in Coos Bay, OR (3408 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2020-01-31
Peer Specialist Primary Specialty

NUCC Taxonomy Code: 175T00000X

State License OR 19-CRM-044

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.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Mhacbo
19-CRM-044 (OR)

Secondary Practice Locations

125 Sw C St

Madras, OR 977411458

Phone: 5413064566

1435 Ne 4th St Ste B

Bend, OR 977014268

Phone: 5413064446

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

31 Associated Practitioners
Sarah Tucker , CRM

Peer Specialist

NPI 1003445875
Jason Paul , PSS, CRM

Peer Specialist

NPI 1013487404
William Stone , CRM

Peer Specialist

NPI 1013536986
Kassie Libbett

Peer Specialist

NPI 1063251783
Kelly Herzog

Peer Specialist

NPI 1073226890
Tasha Walter , CADC 1, CRM, PSS

Counselor - Addiction (Substance Use Disorder)

NPI 1114499324

CADC1, CRM, PSS

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location January 31, 2020

Registered at 155 S EMPIRE BLVD, COOS BAY, OR 974203374 (Tel: 5412564686)

📍
Updated Business Mailing Address January 31, 2020

Registered at 1942 SHERIDAN AVE, NORTH BEND, OR 974593416 (Tel: 5412564686)

NPI Profile Active February 15, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location February 15, 2019

Registered at 1435 NE 4TH ST STE B, BEND, OR 977014268 (Tel: 5413064446)

📍
Updated Business Mailing Address February 15, 2019

Registered at 1435 NE 4TH ST STE B, BEND, OR 977014268 (Tel: 5413064446)

👤
Provider Name / Credentials Updated February 15, 2019

Recorded as ANTHONY WILSON, CRM

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 15, 2019

Peer Specialist (License #19-CRM-044 in OR)

🟢
Initial NPI Registration & Enumeration February 15, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1396201216
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 15, 2019
Last Update: January 31, 2020
Sole Proprietor: No

Mailing Address

1942 Sheridan Ave

North Bend, OR 974593416

Phone: 5412564686

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.