NPIMap

Individual provider Active NPI

Carissa Leigh Honeycutt, PA-C

  • Pediatrics Physician
  • Bend, OR
National Provider Identifier
1245561273
Registry record updated Jan 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
PA150369 Issued in OR
Practice address
2200 NE Professional CT.
Bend, OR 97701
Phone
(541) 389-6316
Fax
(541) 389-8760
NPI assigned
Jan 14, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X PA150369 OR Primary

Addresses

Primary practice location

2200 NE Professional CT.
Bend, OR 97701

Mailing address

1820 NW Monterey Pines
Bend, OR 97701
Phone (541) 322-0019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA150369ORMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Oregon Pediatric Associates Subspecialty Pediatrics Past Accepting new patients
Central Oregon Pediatric Associates Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: choneycutt@copa.gwaydirect.com
  • Direct secure messaging: choneycutt101936@direct.lhs.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1263427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263427200000",
    "number": "1245561273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 NW MONTEREY PINES",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97701",
            "telephone_number": "541-322-0019",
            "fax_number": "541-322-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 NE PROFESSIONAL CT.",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97701",
            "telephone_number": "541-389-6316",
            "fax_number": "541-389-8760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HONEYCUTT",
        "first_name": "CARISSA",
        "middle_name": "LEIGH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-14",
        "last_updated": "2010-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "PA150369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2010; 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.