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TIM RAY KELLY
NPI 1003535386
Peer Specialist in Lincoln City, OR

Active since August 22, 2022
1221 NW HIGHWAY 101 STE A, LINCOLN CITY, OR 97367(442) 244-1336 Get Directions Write a Review

NPPES record last updated: August 22, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Tim Ray Kelly NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIM RAY KELLY (NPI 1003535386) is an individual peer specialist in Lincoln City, Oregon, licensed in Oregon (THW000106995) and active in the NPI registry since August 2022.

NPPES Registry Identity

NPI1003535386
Entity TypeIndividualMale
Primary Taxonomy175T00000X
Provider Legal NameTIM RAY KELLY
Location Address1221 NW HIGHWAY 101 STE ALincoln City, OR 97367-3351
Mailing Address1221 Nw Highway 101 Ste ALincoln City, OR 97367-3351 · (971) 727-5471
Phone(442) 244-1336
Sole ProprietorYes
Enumeration DateAugust 22, 2022
NPPES CertifiedAugust 22, 2022
✔ NPI 1003535386 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
License✔ Licensed in OR · THW000106995
Definition
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.
1221 NW HIGHWAY 101 STE A, Lincoln City, OR 97367
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tim Kelly's NPI number?

The NPI number for Tim Kelly is 1003535386. It was assigned to this individual provider in the NPPES registry on August 22, 2022.

Where is Tim Kelly located?

Tim Kelly practices at 1221 NW Highway 101 Ste A, Lincoln City, OR 97367. The listed phone number is (442) 244-1336.

What is Tim Kelly's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Tim Kelly was last updated on August 22, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.