Active NPI
Psychmatters LLC
- Psychiatric/Mental Health Nurse Practitioner
- Portland, OR
National Provider Identifier
1366192205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- Legal business name
- PSYCHMATTERS LLC
- Practice address
- 4805 NE Glisan St
Portland, OR 97213-2933 - Phone
- (888) 315-8723
- NPI assigned
- Mar 24, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Paul Stewart, PMHNP-BC, PHD
- Title
- Owner
- Phone
- (888) 315-8723
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | Primary |
Addresses
Primary practice location
4805 NE Glisan St
Portland, OR 97213-2933
Mailing address
30 N Gould St Ste R
Sheridan, WY 82801-6317
Phone (888) 315-8723
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648080000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1648080000000",
"number": "1366192205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 N GOULD ST STE R",
"city": "SHERIDAN",
"state": "WY",
"postal_code": "828016317",
"telephone_number": "888-315-8723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4805 NE GLISAN ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972132933",
"telephone_number": "888-315-8723"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PSYCHMATTERS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-03-24",
"last_updated": "2022-03-24",
"certification_date": "2022-03-24",
"status": "A",
"authorized_official_last_name": "STEWART",
"authorized_official_first_name": "PAUL",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "888-315-8723",
"authorized_official_credential": "PMHNP-BC, PHD"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; 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.