Active NPI
Monica M Wahls, FNP, PMHNP
- Psychiatric/Mental Health Nurse Practitioner
- Bend, OR
National Provider Identifier
1922071182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 201391720NP-PP
- Practice address
- 1501 NE Medical Center Dr
Bend, OR 97701-6051 - Phone
- (541) 382-4900
- Fax
- (541) 706-2398
- NPI assigned
- Feb 8, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 201391720NP-PP | OR | Primary |
| Nurse Practitioner | 363L00000X | 200150011NP-FNP-PP | OR |
Addresses
Primary practice location
1501 NE Medical Center Dr
Bend, OR 97701-6051
Mailing address
PO Box 6048
Bend, OR 97708-6048
Phone (541) 382-4900
Other practice location 1
800 SW 13th Ave
Portland, OR 97205-1902
Phone (503) 221-0161
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| J406428 | Other | OR | IND PACSOURCE |
| 000188021 | Other | OR | IND BLUE CROSS |
| 500027207 | Other | OR | IND RAILROAD |
| 000164 | Medicaid | OR |
Other names 1
- Miss Monica M Yedinak
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mwahls19057@directmsg.bmctotalcare.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200150011NP-FNP-PP | OR | MD | Nurse Practitioner |
| 201391720NP-PP | OR | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Evergreen Family Medicine, PC | Past | Accepting new patients |
Interoperability endpoints
- mwahls19057@directmsg.bmctotalcare.com
- https://api.platform.athenahealth.com/1334/brand/1/csg/42/fhir/r4
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.
-
- Family Medicine Physician
- Roseburg, OR
- NPI 1417929050
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651622400000",
"number": "1922071182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6048",
"city": "BEND",
"state": "OR",
"postal_code": "977086048",
"telephone_number": "541-382-4900",
"fax_number": "541-706-2398"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 NE MEDICAL CENTER DR",
"city": "BEND",
"state": "OR",
"postal_code": "977016051",
"telephone_number": "541-382-4900",
"fax_number": "541-706-2398"
}
],
"practiceLocations": [
{
"address_1": "800 SW 13th Ave",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972051902",
"country_code": "US",
"telephone_number": "503-221-0161",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WAHLS",
"first_name": "MONICA",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "FNP, PMHNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-08",
"last_updated": "2022-05-04",
"certification_date": "2022-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "OR",
"license": "201391720NP-PP",
"primary": true
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OR",
"license": "200150011NP-FNP-PP",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IND PACSOURCE",
"identifier": "J406428",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IND BLUE CROSS",
"identifier": "000188021",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IND RAILROAD",
"identifier": "500027207",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000164",
"state": "OR"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mwahls19057@directmsg.bmctotalcare.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1501 NE Medical Center Dr",
"city": "Bend",
"state": "OR",
"country_code": "US",
"postal_code": "977016051",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "MONICA",
"last_name": "YEDINAK",
"middle_name": "M",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
}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 May 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.