Jamie Nadine Mayo, PHD, PMHNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

202110251NP Issued in OR

Practice address

625 Virginia Ave Ste 1
North Bend, OR 97459-3425

Phone

(830) 370-3765

NPI assigned

Sep 7, 2021

Last updated

Oct 2, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sulis Mind and Body LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Coos Bay, OR
  • NPI 1528762390
  Medicare reassignment NPD Authorized official
• North Bend Medical Center Inc

  dba NBMC-Main

  • Multi-Specialty Clinic/Center
  • Coos Bay, OR
  • NPI 1407812365
  Medicare reassignment NPD

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

{
    "created_epoch": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1548939218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63673 SEVEN DEVILS RD",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974207679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 VIRGINIA AVE STE 1",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974593425",
            "telephone_number": "830-370-3765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYO",
        "first_name": "JAMIE",
        "middle_name": "NADINE",
        "name_prefix": "Dr.",
        "credential": "PHD, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-07",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "202100949RN",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "202110251NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Regina D Martin
• Zachary Martin
• Tera Lei Martinez
• Michael Anthony Ryan Martins, DDS
• David Mayfield
• Madisan McCabe
• Erin Lee McClelland, LCSW
• McCrae Management & Investment, LTD (NewSound Hearing Aid Centers)
• Kyle W McCullough
• David McDaniel

• Nurse Practitioner in North Bend, OR
• Providers in North Bend, OR by specialty
• Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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.

Verify at the official NPI Registry.