PEACE OF MIND FUNCTIONAL MEDICINE (NPI# 1083240386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083240386 |
| Entity Type | Organization |
| Organization Name | PEACE OF MIND FUNCTIONAL MEDICINE |
| Practice Address |
151 Sw Shevlin Hixon Dr Ste 201 Bend OR 97702-3233 |
| Practice Telephone | 4582029231 |
| Practice Fax Number | 5417976113 |
| Mailing Telephone | 4582029231 |
| Mailing Fax Number | 5417976113 |
| Enumeration Date | 2020-03-18 |
| Last Update Date | 2020-03-18 |
| Authorized Official Name | MARY KATE COPPEDGE (OWNER) |
| Authorized Official Telephone | 5412229231 |
| Authorized Official Credential | PMHNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 1194057661 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | PEACE OF MIND FUNCTIONAL MEDICINE, LLC | 151 Sw Shevlin-hixon Dr Ste 201, Bend, OR 97702 |
| Street Address |
151 SW SHEVLIN HIXON DR STE 201 |
| City | BEND |
| State | OR |
| Zip Code | 97702-3233 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629676259 | Amy Michelle Anderson | Counselor | 233 Sw Wilson Ave, Ste 201, Bend, OR 97702 | 2020-10-15 |
| 1386259463 | Jacob Rehder | Counselor | 19717 Mt Batchelor Dr, #226, Bend, OR 97702 | 2020-09-15 |
| 1497385215 | Capacity Performance Therapy | Physical Medicine & Rehabilitation | 61125 Lodgepole Dr., Bend, OR 97702 | 2020-01-21 |
| 1962041707 | Shift Bend Functional Medicine | Family Medicine | 151 Sw Shevlin Hicks Dr, Suite #1, Bend, OR 97702 | 2019-12-26 |
| 1609435049 | Praxis Medical Group Inc | Orthopaedic Surgery | 1140 Sw Simpson Avenue, Suite 100, Bend, OR 97702 | 2019-06-10 |
| 1013485754 | Elana Leah Pesah | Social Worker | 138 Maaglei Harim Levin, Jerusalem, ISRAEL 97702 | 2018-11-12 |
| 1104303239 | Kyleigh Mcvey | Massage Therapist | 999 Sw Disk Dr, Bend, OR 97702 | 2018-07-21 |
| 1477042869 | Siloe Castaneda Huerta | Counselor | 1340 Nw Wall, Bend, Or, Bend, OR 97702 | 2018-05-02 |
| 1164910808 | Rebecca M Joyce | Social Worker | 1011 Sw Emkay Dr. Suite 101, Bend, OR 97702 | 2018-04-27 |
| 1093217978 | Jennifer Bury | Acupuncturist | 296 Sw Columbia St Ste D1, Bend, OR 97702 | 2018-03-06 |
| Find all providers in zip 97702 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326672726 | Meadowlark Consulting Inc | Clinic/Center | 625 Nw Colorado Ave, Bend, OR 97703-3257 | 2020-02-25 |
| 1003327925 | Thriving Families LLC | Clinic/Center | 335 Ne Revere Ave, Bend, OR 97701-4059 | 2017-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619599545 | Rework Behavioral Therapy, LLC | Clinic/Center | 7724 Se Aspen Summit Dr Ste 300, Portland, OR 97266-9217 | 2020-05-14 |
| 1447871066 | Sande School of Horsemanship | Clinic/Center | 33836 Bennett Rd, Warren, OR 97053-9706 | 2020-05-05 |
| 1740812809 | Inhousedoc, Inc. | Clinic/Center | 23334 Sw Saint Charles Way, Sherwood, OR 97140-9483 | 2020-02-06 |
| 1033740204 | Cascade Therapy Center, LLC | Clinic/Center | 4531 Se Belmont St Ste 106, Portland, OR 97215-1675 | 2020-01-28 |
| 1043861222 | Renewing Strength Counseling LLC | Clinic/Center | 4509 S 6th St Ste 310, Klamath Falls, OR 97603-4883 | 2019-09-27 |
| 1205338365 | Youth Era | Clinic/Center | 44 W Broadway Ste 225, Eugene, OR 97401-3071 | 2018-03-05 |
| 1730598038 | Benton County | Clinic/Center | 4077 Sw Research Way, Corvallis, OR 97333-1065 | 2014-08-12 |
| 1801177902 | Cascade Counseling and Assessment | Clinic/Center | 516 Se Morrison St Ste 705, Portland, OR 97214-2347 | 2011-09-01 |
| 1932435377 | County of Lincoln | Clinic/Center | 322 Ne Eads St, Newport, OR 97365-2819 | 2009-10-20 |
| 1760718100 | Lincoln County Health and Human Services | Clinic/Center | 320 Lower Crestline Dr., Waldport, OR 97394 | 2009-10-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.