Juliana Ayres, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

201802512NP-PP Issued in OR

Practice address

190 Oak St Apt 4
Ashland, OR 97520-1886

Phone

(541) 422-3851

Fax

(541) 325-4827

NPI assigned

Sep 1, 2016

Last updated

Mar 5, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Juliana McClintock Ayres Doherty Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 1, 2024 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Illume Integrative Psychiatry, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Ashland, OR
  • NPI 1861264285
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1003362617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 OAK ST APT 4",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975201886",
            "telephone_number": "541-422-3851",
            "fax_number": "541-325-4827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 OAK ST APT 4",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975201886",
            "telephone_number": "541-422-3851",
            "fax_number": "541-325-4827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYRES",
        "first_name": "JULIANA",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-01",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "2018004137",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201802512NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PMHNP LISCENSE NUMBER",
            "identifier": "201802512NP-PP",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIANA",
            "last_name": "AYRES DOHERTY",
            "middle_name": "MCCLINTOCK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ashland's Optical Expressions, PC
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• Authentic Healing Inc
• Autumn Doshier Counseling LLC
• Elizabeth Backus
• Ashley Bactista, BA
• Marie Bagley
• Lisa Gaye Bailey, MD
• Janet Kay Baker, PH.D.

• Psychiatric/Mental Health Nurse Practitioner in Ashland, OR
• Providers in Ashland, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.