Coaction, Inc.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

COACTION, INC.

Doing business as

Mid-Valley Pain Clinic

Practice address

3723 Fairview Industrial Dr SE Ste 170
Salem, OR 97302-1174

Phone

(503) 371-1970

Fax

(503) 371-0192

NPI assigned

Jun 26, 2008

Organization subpart

No

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

Authorized official

Name

Shelly R CarlsonNPI 1174146948

Title

Owner

Phone

(503) 371-1970

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mid-Valley Pain Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Salem Psychiatric Associates PC

  dba Valley Mental Health

  • Clinical Social Worker
  • Salem, OR
  • NPI 1912121526

  O20040430000049

  Same enrollment
• Salem Psychiatric Associates, P.C.

  dba Valley Mental Health

  • Psychiatry Physician
  • Salem, OR
  • NPI 1619061314

  O20040430000049

  Same enrollment

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shelly R Carlson, QMHA

  • Rehabilitation Practitioner
  • Salem, OR
  • NPI 1174146948
  NPD Authorized official
• Giorgianna Carlisle

  • Behavior Analyst
  • Monrovia, CA
  • NPI 1811685183
  NPD
• Amy Lee Tucker, LPC

  • Mental Health Counselor
  • Salem, OR
  • NPI 1376059063
  NPD (past)
• Mary Claire Woster, LPC, NBCC

  • Mental Health Counselor
  • Anchorage, AK
  • NPI 1740720184
  NPD (past)

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569196800000",
    "number": "1275795619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3723 FAIRVIEW INDUSTRIAL DR SE STE 170",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973021174",
            "telephone_number": "503-371-1970",
            "fax_number": "503-371-0192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3723 FAIRVIEW INDUSTRIAL DR SE STE 170",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973021174",
            "telephone_number": "503-371-1970",
            "fax_number": "503-371-0192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COACTION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-26",
        "last_updated": "2019-09-23",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-371-1970"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500617813",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mid-Valley Pain Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinic/Center in Salem, OR
• Providers in Salem, OR by specialty
• Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.