Mark Daniels, PCNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

201810942NP-PP Issued in OR

Practice address

340 9TH St
Florence, OR 97439

Phone

(541) 902-1634

Fax

(541) 902-9702

NPI assigned

Aug 6, 2014

Last updated

May 28, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1407283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559001600000",
    "number": "1245649029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 SE 164TH AVE DEPT 358",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986838004",
            "telephone_number": "360-729-1412",
            "fax_number": "360-729-3025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 9TH ST",
            "city": "FLORENCE",
            "state": "OR",
            "postal_code": "97439",
            "telephone_number": "541-902-1634",
            "fax_number": "541-902-9702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3415 SE Powell Blvd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972023371",
            "country_code": "US",
            "telephone_number": "503-234-9591",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "826 Anthony Dr.",
            "address_purpose": "LOCATION",
            "city": "Anthony",
            "state": "NM",
            "postal_code": "88021",
            "country_code": "US",
            "telephone_number": "575-201-5135",
            "fax_number": "575-201-5131",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 W Griggs Ave",
            "address_purpose": "LOCATION",
            "city": "Las Cruces",
            "state": "NM",
            "postal_code": "880011235",
            "country_code": "US",
            "telephone_number": "575-647-2800",
            "fax_number": "575-647-2898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "MARK",
        "credential": "PCNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-06",
        "last_updated": "2019-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "53268",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201810942NP-PP",
            "primary": true
        },
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "OR",
            "license": "201402362RN",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Confederated Tribes of Coos, Lower Umpqua & Siuslaw Indians (Three Rivers Health Center - Florence)
• Kim P Corvin, R.N.
• Debra D Cox
• Eula Marie Crippen, PHD
• Shannon E Curry
• Matthew J Danigelis, MD
• Marilyn A Datzman, M.D.
• Brandy Davenport, CADC
• William T. Day, M.D.
• Alicia Denicola, PHD

• Psychiatric/Mental Health Nurse Practitioner in Florence, OR
• Providers in Florence, 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 May 28, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.