Nicole Pantley

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

1160 Liberty St SE
Salem, OR 97302-4143

Phone

(503) 351-4438

Fax

(503) 315-2019

NPI assigned

Nov 16, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• CRC Health Oregon, LLC

  • Methadone Clinic
  • Salem, OR
  • NPI 1427397074
  NPD (past)
• CRC Health Oregon, LLC

  • Methadone Clinic
  • Albany, OR
  • NPI 1811561731
  NPD (past)

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

{
    "created_epoch": "1479254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1992247316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 LIBERTY ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024143",
            "telephone_number": "503-226-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 LIBERTY ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024143",
            "telephone_number": "503-351-4438",
            "fax_number": "503-315-2019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17 SW Frazer Ave Ste 282",
            "address_purpose": "LOCATION",
            "city": "Pendleton",
            "state": "OR",
            "postal_code": "978010048",
            "country_code": "US",
            "telephone_number": "541-278-6330",
            "fax_number": "541-278-5419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANTLEY",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-16",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara G Paluska, DDS
• John Vincent Pendon Pan
• Marc Andre Panet-Raymond, D.D.S.
• Kristin Lenore Pankratz, MSW
• Alexis Panther
• Roxcella Paoff
• Maria J Papendieck, PTA
• Rebecca Papendieck, LMT
• Anthony George Pappas, M.D.
• Carla Paradine

• Addiction (Substance Use Disorder) Counselor in Salem, OR
• Providers in Salem, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; 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.