NPIMap

Organization Active NPI

Precision Mental Performance LLC

Doing business as NeuStart Psychiatry

  • Psychiatric/Mental Health Nurse Practitioner
  • Bend, OR
National Provider Identifier
1881348647
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
PRECISION MENTAL PERFORMANCE LLC
Doing business as
NeuStart Psychiatry
Practice address
550 NW Franklin Ave Ste 268
Bend, OR 97703-2894
Phone
(503) 379-1902
NPI assigned
Feb 9, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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

Authorized official

Name
Lawrence K Robbins, RN
Title
General Manager
Phone
(503) 379-1902

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

550 NW Franklin Ave Ste 268
Bend, OR 97703-2894

Mailing address

2110 Mission St SE Ste 305
Salem, OR 97302-0038
Phone (503) 379-1902

Other identifiers 1

IdentifierTypeStateIssuer
500754977MedicaidOR

Other names 1

  • NeuStart Psychiatry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Neustart Psychiatry4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

550 NW Franklin Ave
Ste 268
Bend, OR 97703
Phone (503) 379-1902

Practitioners & affiliated clinicians

Practitioners 10

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": "1644364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663027200000",
    "number": "1881348647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 MISSION ST SE STE 305",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973020038",
            "telephone_number": "503-379-1902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 NW FRANKLIN AVE STE 268",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977032894",
            "telephone_number": "503-379-1902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRECISION MENTAL PERFORMANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-09",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A",
        "authorized_official_last_name": "ROBBINS",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "503-379-1902",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500754977",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NeuStart Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NeuStart 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 Sep 13, 2022; 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.