Amanda Leigh Peats, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

202105310NP-PP Issued in OR

Practice address

3939 NE Hancock St Ste 303
Portland, OR 97212-5321

Phone

(619) 733-9698

NPI assigned

Jun 8, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Amanda Leigh Adams Former name

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

Practice roles

Locations

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.

• Rise Up Mental Health, LLC.

  • Adult Mental Health Clinic/Center
  • Portland, OR
  • NPI 1225777907

  Psychiatric/Mental Health

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1336716372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10912 NE 104TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986623322",
            "telephone_number": "619-733-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 NE HANCOCK ST STE 303",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972125321",
            "telephone_number": "619-733-9698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEATS",
        "first_name": "AMANDA",
        "middle_name": "LEIGH",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-08",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "202105310NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "ADAMS",
            "middle_name": "LEIGH",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Theodore Lee Pearson III, CADC I
• Tuesday Elizabeth Pearson, D.O.
• Susan Pease Banitt, LCSW
• Letha Pease, LMT
• David Blanchard Peaslee, M.D.
• Deziare Pebenito, LMT
• Sean Paul Pebler, CADC
• Mark Pechovnik, LCSW
• Gabriel Adrian Peck-Frame, DO
• Amy Samantha Peck

• Psychiatric/Mental Health Nurse Practitioner in Portland, OR
• Providers in Portland, 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 Jun 8, 2021; 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.