Amity Mental Wellness LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

AMITY MENTAL WELLNESS LLC

Practice address

147 Commercial St NE Ste 7
Salem, OR 97301-3418

Phone

(813) 458-7232

NPI assigned

Sep 26, 2023

Last updated

Sep 26, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lauri CodyNPI 1558938902

Title

Owner of Entity

Phone

(813) 458-7232

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lauri Cody

  • Psychiatric/Mental Health Nurse Practitioner
  • Annapolis, MD
  • NPI 1558938902

  DC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1695686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695686400000",
    "number": "1417736620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 COMMERCIAL ST NE STE 7",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013418",
            "telephone_number": "813-458-7232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 COMMERCIAL ST NE STE 7",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013418",
            "telephone_number": "813-458-7232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMITY MENTAL WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A",
        "authorized_official_last_name": "CODY",
        "authorized_official_first_name": "LAURI",
        "authorized_official_title_or_position": "OWNER OF ENTITY",
        "authorized_official_telephone_number": "813-458-7232"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Salem, OR
• Providers in Salem, 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 Sep 26, 2023; 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.