Active NPI
Carla Ann Warren, APRN
- Psychiatric/Mental Health Nurse Practitioner
- Corvallis, OR
National Provider Identifier
1912555988
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 10032272
- Practice address
- 883 NW Grant Ave
Corvallis, OR 97330-4539 - Phone
- (541) 320-9555
- Fax
- (541) 316-7329
- NPI assigned
- Sep 3, 2019
- Reactivated
- Nov 11, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 10032272 | OR | Primary |
Addresses
Primary practice location
883 NW Grant Ave
Corvallis, OR 97330-4539
Mailing address
PO Box 16308
Portland, OR 97292-0308
Phone (503) 255-2343
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 1, 2025 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10032272 | OR | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest ADHD Treatment Center | Psychiatric/Mental Health | Past | Accepting new patients |
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.
-
- Psychiatric/Mental Health Nurse Practitioner
- Portland, OR
- NPI 1225459548
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732665600000",
"number": "1912555988",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 16308",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972920308",
"telephone_number": "503-255-2343",
"fax_number": "503-255-2344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "883 NW GRANT AVE",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973304539",
"telephone_number": "541-320-9555",
"fax_number": "541-316-7329"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARREN",
"first_name": "CARLA",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-03",
"last_updated": "2024-11-27",
"certification_date": "2024-11-27",
"deactivation_date": "2024-10-31",
"reactivation_date": "2024-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "OR",
"license": "10032272",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corvallis, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.