At Home Psychiatry LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

200850112NP Issued in OR

Legal business name

AT HOME PSYCHIATRY LLC

Practice address

7975 SW 83Rd Ave
Portland, OR 97223-7334

Phone

(888) 667-6467

Fax

(888) 667-6467

NPI assigned

Sep 17, 2017

Organization subpart

No

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

Authorized official

Name

Mindy Milar Moore, PMHNPNPI 1174792998

Title

Owner

Phone

(888) 667-6467

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

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

• Mindy Milar Moore, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
  • NPI 1174792998

  OR

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1505606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549497600000",
    "number": "1407375801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8959 SW BARBUR BLVD STE 115",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972194032",
            "telephone_number": "888-667-6467",
            "fax_number": "888-667-6467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7975 SW 83RD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972237334",
            "telephone_number": "888-667-6467",
            "fax_number": "888-667-6467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AT HOME PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-17",
        "last_updated": "2019-02-07",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "MINDY",
        "authorized_official_middle_name": "MILAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "888-667-6467",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OR",
            "license": "200850112NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500623422",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karla Maria Asturias Gonzalez, M.D.
• Asula Chiropractic and Wellness Center, Inc.
• Elexis Elaine Asuncion
• Jessica Michaels Asuncion, LPN
• At Home Primary Care LLC.
• Gregory Mark Atack, DMD, FAGD
• Jessica Marie Atalla, CRC, LPC
• Joshua Raphael Atanasio, MSW
• Carrie Leigh Hamby Atcheson, MD, MPH
• Jacob Atchley

• All providers in Portland, OR
• Community/Behavioral Health Agency in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.