Athena Medical & Wellness LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

ATHENA MEDICAL & WELLNESS LLC

Practice address

3688 Chester St
North Bend, OR 97459-2418

Phone

(541) 283-5662

Fax

(541) 866-3688

NPI assigned

Jan 19, 2024

Organization subpart

No

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

Authorized official

Name

Pei HarrisNPI 1366825341

Title

Owner

Phone

(541) 283-5662

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Practitioners 1

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

• Pei J Harris, DNP, FNP-C

  • Family Nurse Practitioner
  • North Bend, OR
  • NPI 1366825341
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1705622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705622400000",
    "number": "1801657572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3688 CHESTER ST",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974592418",
            "telephone_number": "541-283-5662",
            "fax_number": "541-866-3688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3688 CHESTER ST",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974592418",
            "telephone_number": "541-283-5662",
            "fax_number": "541-866-3688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHENA MEDICAL & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-19",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "PEI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-283-5662"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gilbert Jason Almeida
• Alternative Actions Manual Therapy LLC
• Rebecca Ambrose
• Craig Anderson, QMHP, LCSW
• Ryan Arellano
• Alyssa Augustson
• Stefanie Austin, OTR/L
• Susan Primrose Aviotti, LPS
• Kathleen B Azab, QMHP, MS
• Cato Jeanette Badenhorst, RPH

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.