Adrienne J Maynard, DNP, PMHNP BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

200850148NP Issued in OR

Practice address

1245 Edgewater St NW
Salem, OR 97304-4049

Phone

(503) 588-5816

Fax

(503) 588-5803

NPI assigned

Jan 31, 2007

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

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Clinicops LLCGroup PAC ID 9739343245, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: adrienne.maynard.1@32746.direct.athenahealth.com

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

• Clinicops, LLC

  • Family Medicine Physician
  • Portland, OR
  • NPI 1275821266

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Vida Family Medicine, LLC

  • Family Medicine Physician
  • Salem, OR
  • NPI 1063567832
  NPD
• Clinicops LLC

  • Internal Medicine Physician
  • Florence, OR
  • NPI 1497251268
  NPD (past)
• Groundswell Integrative Healthcare Inc.

  • Family Medicine Physician
  • Salem, OR
  • NPI 1457790826
  NPD (past)

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320192000000",
    "number": "1063559094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 EDGEWATER ST NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973044049",
            "telephone_number": "503-588-5816",
            "fax_number": "503-588-5803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 EDGEWATER ST NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973044049",
            "telephone_number": "503-588-5816",
            "fax_number": "503-588-5803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "ADRIENNE",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "DNP, PMHNP BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2011-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "09248",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "200850148NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Automn Lee May
• Caryl Elizabeth May
• Lilian May, PHARMD
• William S.T. Mayhall, MD
• Annie Mayhugh
• Bryana Noel Mayne
• Albert John Maziarz, D.D.S.
• Jennifer N MC Kee
• Roxanne McAnally
• Allison R McBride, PT, DPT, PRPC

• Psychiatric/Mental Health Nurse Practitioner in Salem, OR
• Providers in Salem, 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 Nov 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.