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Fifth Corner Academy

Child & Adolescent Psychiatry Physician in Mcminnville, OR · enumerated 2019 · authorized official Roxanne Wilson, President/Program Administrator.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1033753231

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Registry record

Entity type Organization (Type 2)
Legal business name Fifth Corner Academy
Other name <Unavail>
Practice address 1900 Ne Highway 99w Ste K, Mcminnville, OR, 97128
Phone (503) 472-4511
Fax (503) 714-6306
Enumeration date Oct 30, 2019
Last updated in NPPES Mar 28, 2020

Taxonomy & classification

101YM0800X Mental Health Counselor Behavioral Health & Social Service Providers Secondary
133NN1002X Nutrition Education Nutritionist Dietary & Nutritional Service Providers Secondary
163W00000X Registered Nurse Nursing Service Providers Secondary
171M00000X Case Manager/Care Coordinator Other Service Providers Secondary
172A00000X Driver Other Service Providers Secondary
1744R1102X Research Study Specialist Other Service Providers Secondary
174H00000X Health Educator Other Service Providers Secondary
175T00000X Peer Specialist Other Service Providers Secondary
2084P0804X Child & Adolescent Psychiatry Physician Allopathic & Osteopathic Physicians Primary
405300000X Prevention Professional Other Service Providers Secondary

Authorized official

Name Roxanne Wilson
Title President/Program Administrator
Phone (503) 714-6306

Other identifiers

Identifier Type State Issuer
1851475099 Medicaid OR -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Who is the authorized official for Fifth Corner Academy?
NPPES lists Roxanne Wilson (President/Program Administrator) as the authorized official for this organization.
What is the NPI number for Fifth Corner Academy?
The NPI for Fifth Corner Academy is 1033753231, a Type 2 (organization) record in the CMS NPPES registry.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2020-03-28.