Angela M Carlson, APRN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

10006742 Issued in OR

Practice address

2600 NE Highway 101 Ste 200
Lincoln City, OR 97367-4464

Phone

(541) 921-3584

Fax

(541) 614-1291

NPI assigned

Mar 1, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Angela M Sivers Former name

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Christine Lynn McCambridgeGroup PAC ID 6608284385, 7 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

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.

• Christine Lynn McCambridge

  • Psychiatric/Mental Health Nurse Practitioner
  • Lincoln City, OR
  • NPI 1619570322
  Medicare reassignment Care Compare group NPD
• Willamette Valley Clinics LLC

  • Family Medicine Physician
  • McMinnville, OR
  • NPI 1790740520
  Medicare reassignment NPD
• Renovo Chiropractic LLC

  • Clinic/Center
  • Lincoln City, OR
  • NPI 1710442751
  NPD (past)

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

{
    "created_epoch": "1267401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1598088858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 SE STRATUS AVE",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971286239",
            "telephone_number": "503-435-4557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 NE HIGHWAY 101 STE 200",
            "city": "LINCOLN CITY",
            "state": "OR",
            "postal_code": "973674464",
            "telephone_number": "541-921-3584",
            "fax_number": "541-614-1291"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 SE Stratus Ave",
            "address_purpose": "LOCATION",
            "city": "McMinnville",
            "state": "OR",
            "postal_code": "971286239",
            "country_code": "US",
            "telephone_number": "503-435-4557",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "ANGELA",
        "middle_name": "M",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-01",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201909732RN",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "14899",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10006742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "SIVERS",
            "middle_name": "M",
            "credential": "LMT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Matthew Richard Bowser, MD
• Stacey Lynn Brewer-Dally, RN
• Adriana Buer
• Joseph Robert Bullock, DDS
• Caring for the Pacific LLC
• Tina Marie Carlson, FNP-BC
• Gregory P. Carozza, D.O.
• Heather Braud Carter, RPH
• Kate Gillespie Case, PT
• Michael Golden Cheek, MD

• Psychiatric/Mental Health Nurse Practitioner in Lincoln City, OR
• Providers in Lincoln City, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.

Verify at the official NPI Registry.