IndividualActive
Tim Kelly
NPI 1003535386 · Peer Specialist · Lincoln City, OR
Provider details
- NPI number
- 1003535386
- Entity type
- Individual
- Primary specialty
- Peer SpecialistOther Service Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- THW000106995 (OR)
Specialties & taxonomies
Other Service Providers
Profile Score
Established profile(60/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1221 Nw Highway 101 Ste a
Lincoln City, OR 97367-3351
Phone: (442) 244-1336
Street-level locationGet directions
Mailing address
1221 Nw Highway 101 Ste a
Lincoln City, OR 97367-3351
Registry dates
- Enumerated
- 2022-08-22
- Last updated
- 2022-08-22
- Certified
- 2022-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.