Organization Active NPI

Bright Mind LLC

  • Psychiatry Physician
  • Bend, OR
National Provider Identifier
1588200091
Registry record updated Nov 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
BRIGHT MIND LLC
Practice address
151 SW Shevlin Hixon Dr
Bend, OR 97702-3209
Phone
(541) 717-3033
NPI assigned
Nov 19, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2019

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

Authorized official

Name
Amy Kreutzer Erber, NPNPI 1558689836
Title
Nurse Practitioner Owner, President
Phone
(541) 717-3033

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

151 SW Shevlin Hixon Dr
Bend, OR 97702-3209

Mailing address

121 NW Bond St
Bend, OR 97703-3207
Phone (206) 225-8780

Other identifiers 2

IdentifierTypeStateIssuer
1235449463OtherORNPI- TODD BOIRE
1558689836OtherWANPI - AMY ERBER

Other names 1

  • Bright Mind TMS and Integrative Psychiatry Doing business as

National Provider Directory

National Provider Directory

Locations

151 SW Shevlin Hixon Dr
Bend, OR 97702
Phone (541) 717-3033

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1574121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574121600000",
    "number": "1588200091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 NW BOND ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977033207",
            "telephone_number": "206-225-8780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 SW SHEVLIN HIXON DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023209",
            "telephone_number": "541-717-3033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHT MIND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-19",
        "last_updated": "2019-11-19",
        "status": "A",
        "authorized_official_last_name": "ERBER",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "KREUTZER",
        "authorized_official_title_or_position": "NURSE PRACTITIONER OWNER, PRESIDENT",
        "authorized_official_telephone_number": "541-717-3033",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI- TODD BOIRE",
            "identifier": "1235449463",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI - AMY ERBER",
            "identifier": "1558689836",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bright Mind TMS and Integrative Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; 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.