Niki Desanto Amsden, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

2464 Issued in OR

Practice address

2700 Stewart Parkway
Annex B
Roseburg, OR 97471

Phone

(541) 440-3532

Fax

(541) 440-3554

NPI assigned

Oct 20, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Dr. Niki Andrea Desanto Former name

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Curry Health District

  • Critical Access Hospital
  • Gold Beach, OR
  • NPI 1487696985
  Medicare reassignment NPD
• Curry Health District

  • Rural Health Clinic/Center
  • Gold Beach, OR
  • NPI 1770303968
  NPD

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

{
    "created_epoch": "1413763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424304000000",
    "number": "1497159461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "272 MEDICAL LOOP",
            "address_2": "SUITE E",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "97471",
            "telephone_number": "541-440-3532",
            "fax_number": "541-440-3554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 STEWART PARKWAY",
            "address_2": "ANNEX B",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "97471",
            "telephone_number": "541-440-3532",
            "fax_number": "541-440-3554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMSDEN",
        "first_name": "NIKI",
        "middle_name": "DESANTO",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-20",
        "last_updated": "2015-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 12507",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "OR",
            "license": "2464",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "OR",
            "license": "2464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500679588",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NIKI",
            "last_name": "DESANTO",
            "middle_name": "ANDREA",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amedisys Oregon, L.L.C.
• Faye E Ameredes, DO
• American Dental L.L.C
• Loretta J. Amitrano, FNP
• Jonas Amoah
• Brenda Anderson, LPN
• Douglas Edward Anderson, MD
• Gretchen Anderson, LMT
• Harold F Anderson, M.D.
• Scott Charles Anderson, AU.D

• Clinical Neuropsychologist in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Clinical Neuropsychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2015; 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.