KIMBERLY JAYE RANDALL CADC, CRM
NPI 1669991212
Peer Specialist in Portland, OR

NPI Status: Active since September 14, 2017

Contact Information

1030 NE COUCH ST
PORTLAND, OR
ZIP 97232
Phone: (503) 239-8400
Fax: (503) 239-8406

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

Individual
Female
Peer Specialist

About KIMBERLY RANDALL

This page provides the complete NPI Profile along with additional information for Kimberly Randall, a provider established in Portland, Oregon with a medical specialization in Peer Specialist. The healthcare provider is registered in the NPI registry with number 1669991212 assigned on September 2017. The practitioner's primary taxonomy code is 175T00000X with license number THW1868 (OR). The provider is registered as an individual and her NPI record was last updated 3 years ago.

NPI: 1669991212
Provider Name: KIMBERLY JAYE RANDALL CADC, CRM
Gender: Female
Entity Type: Individual
Location Address: 1030 NE COUCH ST PORTLAND, OR 97232
Location Phone: (503) 239-8400
Location Fax: (503) 239-8406
Mailing Address: 14600 NW CORNELL RD PORTLAND, OR 97229
Mailing Phone: (503) 645-3581
Mailing Fax: (503) 239-8406
Is Sole Proprietor?: Yes
Enumeration Date: 09-14-2017
Last Update Date: 08-31-2023
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Location Map

Secondary Locations

1027 E. Burnside St.
Portland, OR 97214
(503) 239-8400

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.: THW1868
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.

Insurance Plans Accepted

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

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
THW1868	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 1669991212, 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 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 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 → 12 → 1 + 2

Pos 4

Unchanged

Pos 5

Doubled → 18 → 1 + 8

Pos 6

Unchanged

Pos 7

Doubled → 2

Pos 8

Unchanged

Pos 9

Doubled → 2

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 6 → 12 → 3 9 → 18 → 9 1 → 2 1 → 2