Individual provider Active NPI

Amy Patrick, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Eugene, OR
National Provider Identifier
1255761466
Registry record updated Nov 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
201502913NP-PP Issued in OR
Practice address
2145 Centennial PLZ
Eugene, OR 97401
Phone
(541) 485-6340
Fax
(541) 984-3124
NPI assigned
Nov 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 201502913NP-PP OR Primary

Addresses

Primary practice location

2145 Centennial PLZ
Eugene, OR 97401

Mailing address

2145 Centennial PLZ
Eugene, OR 97401-2474
Phone (541) 485-6340

Other practice location 1

805 164th St SE Ste 101
Mill Creek, WA 98012-6316
Phone (425) 742-4600

Other names 1

  • Amy Patrick Chapin Former name

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
I20190201000591 OR Practitioner - Nurse Practitioner 3173753027 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201502913NP-PPORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lane County Oregon CurrentSince Nov 30, 2023 Accepting new patients

Locations

2411 Martin Luther King Jr Blvd
Eugene, OR 97401
Phone (541) 682-3608

1022 Green Acres Rd
Eugene, OR 97408
Phone (541) 682-3551

2073 Olympic St
Springfield, OR 97477
Phone (541) 682-3530

Interoperability endpoints

  • Direct secure messaging: amy.patrick.p1@direct.lanecounty.nextgenshare.com

Organizations & group practices 1

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": "1385337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543449600000",
    "number": "1255761466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2145 CENTENNIAL PLZ",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012474",
            "telephone_number": "541-485-6340",
            "fax_number": "541-984-3124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2145 CENTENNIAL PLZ",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "97401",
            "telephone_number": "541-485-6340",
            "fax_number": "541-984-3124"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "805 164th St SE Ste 101",
            "address_purpose": "LOCATION",
            "city": "Mill Creek",
            "state": "WA",
            "postal_code": "980126316",
            "country_code": "US",
            "telephone_number": "425-742-4600",
            "fax_number": "425-742-4633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "AMY",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-25",
        "last_updated": "2018-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201502913NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "CHAPIN",
            "middle_name": "PATRICK",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.