Melissa Decarlo

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

201393859LPN Issued in OR

Practice address

1160 Liberty St SE
Salem, OR 97302-4143

Phone

(503) 391-9762

Fax

(503) 315-2019

NPI assigned

May 18, 2018

Last updated

May 18, 2018By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• CRC Health Oregon, LLC

  dba Willamette Valley Treatment Center

  • Methadone Clinic
  • Salem, OR
  • NPI 1427397074
  NPD (past)
• CRC Health Oregon, LLC

  dba Albany Comprehensive Treatment Center

  • Methadone Clinic
  • Albany, OR
  • NPI 1811561731
  NPD (past)

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

{
    "created_epoch": "1526601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526601600000",
    "number": "1225528805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 LIBERTY ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024143",
            "telephone_number": "503-391-9762",
            "fax_number": "503-315-2019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 LIBERTY ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024143",
            "telephone_number": "503-391-9762",
            "fax_number": "503-315-2019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECARLO",
        "first_name": "MELISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-18",
        "last_updated": "2018-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OR",
            "license": "201393859LPN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Addison Deboer, PA-C
• Deborah M Johnson MD PC
• Xan K Decambra
• Lindsey Decampos-Stairiker, DPT
• Catherine Elaine Decampos, PSY.D./FNP-BC
• Elisabeth Ruth Decelles, PMHNP
• Jordan Marissa Decker, M.ED., BCBA, LBA
• Cynthia Vermillion Deckert, NURSE
• Dedicated Hearts in-Home Care LLC
• Kathryn Marie Deeds, CADC CANDIDATE

• Licensed Practical Nurse in Salem, OR
• Providers in Salem, OR by specialty
• Licensed Practical Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.