Active NPI
Mackenzie Elaine Minten, RN
- Psychiatric/Mental Health Registered Nurse
- Salem, OR
National Provider Identifier
1962188052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Registered Nurse
- License
- 201909661RN
- Practice address
- 540 Wormwood St SE
Salem, OR 97306-1703 - Phone
- (503) 884-6603
- NPI assigned
- Jun 23, 2023
- Last updated
- Jun 23, 2023
- 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 Registered Nurse | 163WP0808X | 201909661RN | OR | Primary |
Addresses
Primary practice location
540 Wormwood St SE
Salem, OR 97306-1703
Mailing address
540 Wormwood St SE
Salem, OR 97306-1703
Phone (503) 884-6603
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201909661RN | OR | MD | Psychiatric/Mental Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687478400000",
"number": "1962188052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "540 WORMWOOD ST SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973061703",
"telephone_number": "503-884-6603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "540 WORMWOOD ST SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973061703",
"telephone_number": "503-884-6603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINTEN",
"first_name": "MACKENZIE",
"middle_name": "ELAINE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-23",
"last_updated": "2023-06-23",
"certification_date": "2023-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0808X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health",
"state": "OR",
"license": "201909661RN",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.