Individual provider Active NPI

Patricia A Lawrence, MSN, FNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Coburg, OR
National Provider Identifier
1528047677
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
201050043NP Issued in OR
Practice address
1 Serenity LN
Coburg, OR 97408-9350
Phone
(719) 671-0925
NPI assigned
Jan 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APN.0005062-NP CO
Nurse Practitioner 363L00000X RXN.0004043-NP CO
Family Nurse Practitioner 363LF0000X AP0889 AZ
Family Nurse Practitioner 363LF0000X APN.0005062-NP CO
Family Nurse Practitioner 363LF0000X RXN.0004043-NP CO
Family Nurse Practitioner 363LF0000X 201050027NP OR
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APN.0005062-NP CO
Registered Nurse 163W00000X RN063755 AZ
Registered Nurse 163W00000X 087006925RN OR
Registered Nurse 163W00000X RN.0088358 CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RXN.0004043-NP CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 201050043NP OR Primary

Addresses

Primary practice location

1 Serenity LN
Coburg, OR 97408-9350

Mailing address

4175 N Highway 101 Unit B4
Depoe Bay, OR 97341-9729
Phone (719) 671-0925

Other practice location 1

51 SW Lee St
Newport, OR 97365-3823
Phone (541) 574-5960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN063755AZMDRegistered Nurse
RN.0088358COMDRegistered Nurse
087006925RNORMDRegistered Nurse
APN.0005062-NPCOMDNurse Practitioner
RXN.0004043-NPCOMDNurse Practitioner
AP0889AZMDFamily Nurse Practitioner
201050027NPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bright Horizons Psychiatric Group LLC PastSince Mar 6, 2022 Accepting new patients
Groundswell Integrative Healthcare Inc. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1528047677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4175 N HIGHWAY 101 UNIT B4",
            "city": "DEPOE BAY",
            "state": "OR",
            "postal_code": "973419729",
            "telephone_number": "719-671-0925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SERENITY LN",
            "city": "COBURG",
            "state": "OR",
            "postal_code": "974089350",
            "telephone_number": "719-671-0925"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "51 SW Lee St",
            "address_purpose": "LOCATION",
            "city": "Newport",
            "state": "OR",
            "postal_code": "973653823",
            "country_code": "US",
            "telephone_number": "541-574-5960",
            "fax_number": "541-265-0601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "PATRICIA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "MSN, FNP, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-16",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "APN.0005062-NP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "RXN.0004043-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP0889",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0005062-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "RXN.0004043-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201050027NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "APN.0005062-NP",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN063755",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "087006925RN",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "RN.0088358",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "RXN.0004043-NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201050043NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coburg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.