Individual provider Active NPI

Gabriella Amarei, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Grants Pass, OR
National Provider Identifier
1609937283
Registry record updated Nov 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
094006553N6 PMHNP-PP Issued in OR
Practice address
141 NW C St Ste E
Grants Pass, OR 97526-2035
Phone
(541) 948-9243
Fax
(541) 631-2599
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 094006553N6 OR
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 094006553N6 PMHNP-PP OR Primary

Addresses

Primary practice location

141 NW C St Ste E
Grants Pass, OR 97526-2035

Mailing address

PO Box 973
Talent, OR 97540-0973
Phone (541) 948-9243

Other names 1

  • Linda P Kovolisky Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170214002575 OR Practitioner - Nurse Practitioner 2769618073 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4497 Brown Ridge Ter
Suite 104
Medford, OR 97504-9173
Phone (541) 948-9243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
094006553N6 PMHNP-PPORMDPsychiatric/Mental Health Nurse Practitioner

Organizations & group practices 1

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1609937283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 973",
            "city": "TALENT",
            "state": "OR",
            "postal_code": "975400973",
            "telephone_number": "541-948-9243",
            "fax_number": "541-631-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 NW C ST STE E",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975262035",
            "telephone_number": "541-948-9243",
            "fax_number": "541-631-2599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMAREI",
        "first_name": "GABRIELLA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "094006553N6",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "094006553N6 PMHNP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDA",
            "last_name": "KOVOLISKY",
            "middle_name": "P",
            "credential": "PMHNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grants Pass, OR

Sources for this page

Verify at the official NPI Registry.