Shinichi Daimyo, PMHNP-BC, CRNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

202112981NP-PP Issued in OR

Practice address

132 E Broadway Ste 810
Eugene, OR 97401-3160

Phone

(541) 357-9433

NPI assigned

Jan 22, 2018

Last updated

Dec 25, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 9

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Solidarity Mental Health PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Boston, MA
  • NPI 1609726371
  NPD Authorized official

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

{
    "created_epoch": "1516579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703462400000",
    "number": "1275041477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 ALWARD RD",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021327703",
            "telephone_number": "617-237-0455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 E BROADWAY STE 810",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013160",
            "telephone_number": "541-357-9433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAIMYO",
        "first_name": "SHINICHI",
        "name_prefix": "Mr.",
        "credential": "PMHNP-BC, CRNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-22",
        "last_updated": "2023-12-25",
        "certification_date": "2023-12-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VT",
            "license": "101.0134731",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61136881",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NH",
            "license": "084400-23",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2323354",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ME",
            "license": "CNP211039",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP019201",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DC",
            "license": "RN1061501",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F403863-01",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "202112981NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Daggett, RDH, EP
• Jamielynn Nicole Dailey-Riggs
• Eli Joseph Dailey, PHARM. D.
• Thomas P Dailey, DDS
• Kirsten Daily
• Daisy C.H.a.I.N. Creating Healthy Alliances in New-Mothering
• Sabrina J Dake, FNP
• Shanmugapriya Dakshnamoorthy, M.D
• Chad Daley, L.M.T.
• Ruth Abigail Daley, SLP

• Psychiatric/Mental Health Nurse Practitioner in Eugene, OR
• Providers in Eugene, 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 Dec 25, 2023; 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.