Andrea L Nutt, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

201705780NP-PP Issued in OR

Practice address

222 SE Jefferson St
Sheridan, OR 97378-1924

Phone

(503) 843-1535

Fax

(503) 843-1536

NPI assigned

Apr 29, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Icco LLCGroup PAC ID 1355406729, 133 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health Care Home health agency, Roseburg, OR, CCN 387311
• Mercy Medical Center Hospital, Roseburg, OR, CCN 380027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Icco, LLC

  dba BestMed

  • Urgent Care Clinic/Center
  • Eugene, OR
  • NPI 1407004757
  Medicare reassignment Care Compare group NPD
• Northwest Medical Foundation of Tillamook

  dba Adventist Health Tillamook

  • Critical Access Hospital
  • Tillamook, OR
  • NPI 1871575225
  Medicare reassignment NPD
• Icco LLC

  dba BestMed

  • Primary Care Clinic/Center
  • Eugene, OR
  • NPI 1235672478
  NPD
• Icco LLC

  dba BestMed

  • Rural Health Clinic/Center
  • Florence, OR
  • NPI 1740896547
  NPD
• Northwest Medical Foundation of Tillamook

  dba Adventist Health Medical Office - Sheridan

  • Critical Access Hospital
  • Sheridan, OR
  • NPI 1053873919
  NPD
• Northwest Medical Foundation of Tillamook

  dba Adventist Health/Tillamook Medical Group

  • Rural Health Clinic/Center
  • Tillamook, OR
  • NPI 1841451853
  NPD
• Icco, LLC

  dba BestMed

  • Family Medicine Physician
  • Eugene, OR
  • NPI 1992861611
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Amedisys Oregon, L.L.C.

  dba Amedisys Home Health Care

  • Home Health Agency
  • Roseburg, OR
  • NPI 1093908725
  Care Compare affiliation
• Commonspirit Oregon

  dba CHI Mercy Medical Center

  • General Acute Care Hospital
  • Roseburg, OR
  • NPI 1477590198
  Care Compare affiliation

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1093192965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1023",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974700232",
            "telephone_number": "541-440-6390",
            "fax_number": "541-440-6392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 SE JEFFERSON ST",
            "city": "SHERIDAN",
            "state": "OR",
            "postal_code": "973781924",
            "telephone_number": "503-843-1535",
            "fax_number": "503-843-1536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "780 NW Garden Valley Blvd Ste 310",
            "address_purpose": "LOCATION",
            "city": "Roseburg",
            "state": "OR",
            "postal_code": "974712298",
            "country_code": "US",
            "telephone_number": "541-672-4885",
            "fax_number": "541-998-4571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NUTT",
        "first_name": "ANDREA",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-29",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201705780NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Lynn Menne
• Traci J Millsap, RN, BSN, IBCLC
• Kenneth G Mize, DMDPC
• James Patrick Molloy III, M.D.
• Northwest Medical Foundation of Tillamook (Adventist Health Medical Office - Sheridan)
• Monica Adriana Ortega, LMT
• Pacific Rehabilitation & Sports Medicine Inc
• Sapphire at Rivers Edge LLC (Rivers Edge Rehabilitation and Care)
• Elaine V. Schloeder, RDH
• Sheridan Care Center LLC

• Family Nurse Practitioner in Sheridan, OR
• Providers in Sheridan, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.