HEIDI KATHLEEN HICINBOTHOM
NPI 1023534252
Peer Specialist in Grand Ronde, OR

NPI Status: Active since August 18, 2017

Contact Information

9605 GRAND RONDE RD
GRAND RONDE, OR
ZIP 97347
Phone: (503) 879-2026

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Insurance Plans Accepted
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Female
Peer Specialist
Accepts Insurance

About HEIDI HICINBOTHOM

This page provides the complete NPI Profile along with additional information for Heidi Hicinbothom, a provider established in Grand Ronde, Oregon with a medical specialization in Peer Specialist. The healthcare provider is registered in the NPI registry with number 1023534252 assigned on August 2017. The practitioner's primary taxonomy code is 175T00000X with license number THW000001683 (OR). The provider is registered as an individual and her NPI record was last updated 5 years ago.

NPI: 1023534252
Provider Name: HEIDI KATHLEEN HICINBOTHOM
Gender: Female
Entity Type: Individual
Location Address: 9605 GRAND RONDE RD GRAND RONDE, OR 97347
Location Phone: (503) 879-2026
Mailing Address: 9605 GRAND RONDE RD GRAND RONDE, OR 97347
Mailing Phone: (503) 879-2002
Is Sole Proprietor?: Yes
Enumeration Date: 08-18-2017
Last Update Date: 12-02-2021
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Peer Specialist
Taxonomy Code: 175T00000X
Type: Other Service Providers
License No.: THW000001683
License State: OR
Taxonomy Description: 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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No.	Taxonomy Code	Type	Classification / Specialization	License No. (State)
1	101YA0400X	Behavioral Health & Social Service Providers	Counselor Addiction (Substance Use Disorder)	T-21-874 (OR)
2	175T00000X	Other Service Providers	Peer Specialist

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Moda Health Plan, Inc.

Moda Health Affinity Bronze 8000 - EPO
Moda Health Affinity Bronze 9000 - EPO
Moda Health Affinity Bronze HDHP 7500 - EPO
Moda Health Affinity Gold 1000 - EPO
Moda Health Affinity Gold 1500 - EPO
Moda Health Affinity Gold 250 - EPO
Moda Health Affinity Silver 3000 - EPO
Moda Health Affinity Silver 3400 - EPO
Moda Health Affinity Silver 4500 - EPO
Moda Health Affinity Silver 6000 - EPO
Moda Health Oregon Standard Bronze Affinity - EPO
Moda Health Oregon Standard Gold Affinity - EPO
Moda Health Oregon Standard Silver Affinity - EPO

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State	Identifier Issuer
500753908	MEDICAID (05)	OR

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1023534252, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 48. The final step is to find the difference between that total and the next multiple of ten (50 - 48 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 4

Pos 4

Unchanged

Pos 5

Doubled → 10 → 1 + 0

Pos 6

Unchanged

Pos 7

Doubled → 8

Pos 8

Unchanged

Pos 9

Doubled → 10 → 1 + 0

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 5 → 10 → 1 4 → 8 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 4 + 3 + 1 + 0 + 3 + 8 + 2 + 1 + 0 + 24 = 48

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 48 is 50. The difference is the calculated check digit.

50 - 48 = 2

This NPI is valid

The calculated check digit is 2, which matches the last digit of 1023534252.