Kara Lynn Petredis, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

202204007NP-PP Issued in OR

Practice address

1551 Oak St Ste B
Eugene, OR 97401-4023

Phone

(541) 255-1411

NPI assigned

Sep 5, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Kardia Integrative Psychiatry

  • Psychiatric/Mental Health Nurse Practitioner
  • Eugene, OR
  • NPI 1801633649
  NPD Authorized official

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

{
    "created_epoch": "1630800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1912675786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 WILLAMETTE STREET, SUITE 301, #140",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014593",
            "telephone_number": "541-255-1411",
            "fax_number": "541-255-1412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 OAK ST STE B",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014023",
            "telephone_number": "541-255-1411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETREDIS",
        "first_name": "KARA",
        "middle_name": "LYNN",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-05",
        "last_updated": "2023-09-12",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "202204007NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Regan Peterson, RD, LD
• Thomas David Peterson, M.D.
• Heather Marie Petet
• Stephen Pethick, PHD
• Natasa Petrac, M.D.
• Meaghan Petrunic
• Tiffany Rose Petry, LAC
• Patricia Rose Pettit-Blair
• Morgan Layne Pettit
• Adam Pettitt, PHD

• Psychiatric/Mental Health Nurse Practitioner in Eugene, OR
• Providers in Eugene, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; 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.