Individual provider Active NPI

Dina Paula Filoteo-Nichols, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
National Provider Identifier
1770021099
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
202210253NP-PP Issued in OR
Practice address
13908 SE Stark St Ste a
Portland, OR 97233-2161
Phone
(503) 255-2344
NPI assigned
Feb 7, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95021122 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 202210253NP-PP OR Primary
Adult Health Nurse Practitioner 363LA2200X 202210253NP-PP OR
Adult Health Nurse Practitioner 363LA2200X 95021122 CA
Adult Health Nurse Practitioner 363LA2200X RN2296654 MA

Addresses

Primary practice location

13908 SE Stark St Ste a
Portland, OR 97233-2161

Mailing address

61 Lincoln St Ste 203
Framingham, MA 01702-8264
Phone (781) 666-2711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 16, 2023 through Feb 16, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2296654MAMDAdult Health Nurse Practitioner
202210253NP-PPORMDAdult Health Nurse Practitioner
95021122CAMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1486425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1770021099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 LINCOLN ST STE 203",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017028264",
            "telephone_number": "781-666-2711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13908 SE STARK ST STE A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972332161",
            "telephone_number": "503-255-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FILOTEO-NICHOLS",
        "first_name": "DINA",
        "middle_name": "PAULA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-07",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95021122",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "202210253NP-PP",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "202210253NP-PP",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95021122",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "RN2296654",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.