Carol Nightengale P C

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

592 Issued in OR

Legal business name

CAROL NIGHTENGALE P C

Practice address

28467 SE K W Anderson Rd
Gresham, OR 97080-0016

Phone

(503) 669-1095

Fax

(503) 665-3299

NPI assigned

Oct 18, 2012

Organization subpart

No

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

Authorized official

Name

Carol Nightengale, PCNPI 1821179938

Title

Owner

Phone

(503) 669-1095

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 2

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

• Carol Lynn Nightengale, LCSW, PC

  • Clinical Social Worker
  • Gresham, OR
  • NPI 1821179938
  Medicare reassignment Authorized official
• Tiffany Hutchison, MA, LPC, CADC

  • Mental Health Counselor
  • Gresham, OR
  • NPI 1720451578
  NPD (past)

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719878400000",
    "number": "1447503107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1503",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970301506",
            "telephone_number": "503-669-1095",
            "fax_number": "503-665-3299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28467 SE K W ANDERSON RD",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970800016",
            "telephone_number": "503-669-1095",
            "fax_number": "503-665-3299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROL NIGHTENGALE P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-18",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A",
        "authorized_official_last_name": "NIGHTENGALE",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-669-1095",
        "authorized_official_credential": "PC"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "OR",
            "license": "592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiauna Capel
• Christina Caputo, LMT L.AC.
• Kirstin Card, LMT
• Sarah Carl, LMT
• Bonnie Eileen Carlsen
• Kevin R Carpenter, MD
• Noah James Carpine
• Sabrina Carreras
• Nicole E Carroll-Maupin, RN
• Bruce Carter, LMT

• Preferred Provider Organization in Gresham, OR
• Providers in Gresham, OR by specialty
• Preferred Provider Organization in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; 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.