Individual provider Active NPI

Anicka Leah Gabriella Oyer Meyers, PMHNP-BC, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
National Provider Identifier
1225563190
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
201807417NP-PP Issued in OR
Practice address
110 S Bancroft St Ste B
Portland, OR 97239-8523
Phone
(971) 328-1565
NPI assigned
Apr 27, 2017
Last updated
Feb 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 201807417NP-PP OR Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61373216 WA
Registered Nurse 163W00000X RN61368679 WA
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 201607783RN OR

Addresses

Primary practice location

110 S Bancroft St Ste B
Portland, OR 97239-8523

Mailing address

110 S Bancroft St Ste B
Portland, OR 97239-8523

Other practice location 1

1306 NW Hoyt St Ste 407
Portland, OR 97209-2787
Phone (971) 407-3930

Other practice location 2

401 Broadway Ste 100
Tacoma, WA 98402
Phone (971) 328-1565

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20201007003042 OR Practitioner - Nurse Practitioner 7618396870 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN61368679WAMDRegistered Nurse
201607783RNORMDAddiction (Substance Use Disorder) Registered Nurse
201807417NP-PPORMDPsychiatric/Mental Health Nurse Practitioner
AP61373216WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Colorado, P.C. CurrentSince Nov 17, 2024 Accepting new patients
Optum Behavioral Care of Colorado, P.C. Current Accepting new patients
Optum Behavioral Care of Colorado, P.C. CurrentSince Nov 17, 2024 Accepting new patients
Talking Twenties, PLLC Psychiatric/Mental Health Past Accepting new patients

Locations

11000 Optum Cir
Eden Prairie, MN 55344
Phone (888) 445-8745

1306 NW Hoyt St
Ste 407
Portland, OR 97209
Phone (971) 407-3930

Interoperability endpoints

  • Direct secure messaging: anicka.meyers.1@28621.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1225563190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S BANCROFT ST STE B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972398523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S BANCROFT ST STE B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972398523",
            "telephone_number": "971-328-1565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1306 NW Hoyt St Ste 407",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972092787",
            "country_code": "US",
            "telephone_number": "971-407-3930",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 Broadway Ste 100",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "98402",
            "country_code": "US",
            "telephone_number": "971-328-1565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OYER MEYERS",
        "first_name": "ANICKA",
        "middle_name": "LEAH GABRIELLA",
        "credential": "PMHNP-BC, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-27",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201807417NP-PP",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61373216",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN61368679",
            "primary": false
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "201607783RN",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.