Active NPI
Carrie Ellen Valle, FNP-C
- Family Nurse Practitioner
- Coos Bay, OR
National Provider Identifier
1508589607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 10017963
- Practice address
- 1495 Teakwood Ave
Coos Bay, OR 97420-2146 - Phone
- (208) 999-6010
- NPI assigned
- Sep 22, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 10017963 | OR | Primary |
Addresses
Primary practice location
1495 Teakwood Ave
Coos Bay, OR 97420-2146
Mailing address
1495 Teakwood Ave
Coos Bay, OR 97420-2146
Phone (208) 999-6010
Other practice location 1
150 S Wall St
Coos Bay, OR 97420-3233
Phone (360) 531-2099
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500826662 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2590 Woodland Dr
Coos Bay, OR 97420-2050
Phone (541) 217-2022
Hospital & facility affiliations
- Oregon Coast Home Health
- South Coast Hospice
- Bay Area Hospital
- Southern Coos Hospital & Health Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bay Clinic | Single Specialty | Current | Accepting new patients |
| Confederated Tribes of Coos, Lower Umpqua & Siuslaw Indians | Single Specialty | Past | Accepting new patients |
| Nisha Jackson PC | Past | Accepting new patients | |
| Nisha Jackson PC | Past | Accepting new patients |
Locations
1750 Thompson Rd
Coos Bay, OR 97420
Phone (541) 269-0333
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/bea62b1d-5b0c-4c1a-bdbd-eaa129312421/
- carrie.valle.p1@direct.opm.nextgenshare.com
Organizations & group practices 5
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.
-
- Nurse Practitioner
- Medford, OR
- NPI 1124499124
-
- Primary Care Clinic/Center
- Coos Bay, OR
- NPI 1780755454
Single Specialty
-
- Rural Health Clinic/Center
- Coos Bay, OR
- NPI 1275485088
-
- Rural Health Clinic/Center
- North Bend, OR
- NPI 1629920434
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Coos Bay, OR
- NPI 1134801806
-
- General Acute Care Hospital
- Coos Bay, OR
- NPI 1225016561
-
- Community Based Hospice Care Agency
- Coos Bay, OR
- NPI 1417956558
-
- Critical Access Hospital
- Bandon, OR
- NPI 1588684484
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731369600000",
"number": "1508589607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1495 TEAKWOOD AVE",
"city": "COOS BAY",
"state": "OR",
"postal_code": "974202146",
"telephone_number": "208-999-6010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1495 TEAKWOOD AVE",
"city": "COOS BAY",
"state": "OR",
"postal_code": "974202146",
"telephone_number": "208-999-6010"
}
],
"practiceLocations": [
{
"address_1": "150 S Wall St",
"address_purpose": "LOCATION",
"city": "Coos Bay",
"state": "OR",
"postal_code": "974203233",
"country_code": "US",
"telephone_number": "360-531-2099",
"fax_number": "541-888-0025",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VALLE",
"first_name": "CARRIE",
"middle_name": "ELLEN",
"credential": "FNP-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-22",
"last_updated": "2024-11-12",
"certification_date": "2024-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": "OR",
"license": "10017963",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500826662",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Coos Bay, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.