CHARLENE DAVIS (PMHNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1023728573

CHARLENE DAVIS (PMHNP) is a healthcare provider. based in Roseburg, Oregon. specializing in NURSE PRACTITIONER. They hold the professional credentials PMHNP. They hold a License No. 10022152 (OR). The NPI Number for CHARLENE DAVIS (PMHNP) is 1023728573

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
CHARLENE DAVIS (PMHNP)
NPI
1023728573
Phone
(541) 677-7200
Address
2570 NW EDENBOWER BLVD STE 100
Enumeration Date
23 November 2022
Last Update Date
27 February 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5416777200
Graduation Year
2022 (4 years ago)
PAC ID
7416395496
Group Practice PAC ID
9234397878
Professional Enrollment ID
I20240410000777
Address ID
OR974716214RO2570XBLVD401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

3,366 NURSE PRACTITIONER in OR

Provider Addresses for CHARLENE DAVIS (PMHNP)

  • 2570 NW EDENBOWER BLVD STE 100

    ROSEBURG, OR 974716214

    Phone: (541) 677-7200

    Fax: (541) 229-3309

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $149.

Total Amount is formed as General ($149) + Research ($0) + Ownership ($0) = $149.

Last reported payment date: 2024-11-12 • Largest payer in this snapshot: ABBVIE INC. ($99).

Total Amount

$149

General + Research + Ownership

Payments

4

Total payment records

General Amount

$149

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-12

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-04-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240410000777INurse PractitionerORTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97471)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9234397878View full group profile
NameSpecialtyState
Family PracticeOR
Nurse PractitionerOR
Family PracticeOR
Physician AssistantOR
Internal Medicine, Pediatric Medicine, EndocrinologyOR
Physician AssistantOR
Hospitalist, Internal Medicine, Internal Medicine, HospitalistOR
Mental Health CounselorOR
Nurse PractitionerOR
Family PracticeOR

Reviews

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Frequently asked questions

What is the registry number for CHARLENE DAVIS (PMHNP)?
The registry entry for CHARLENE DAVIS (PMHNP) shows NPI 1023728573.
Quick check: is CHARLENE DAVIS (PMHNP) active?
Public NPPES data shows CHARLENE DAVIS (PMHNP) with an active NPI status right now.
What does the directory say CHARLENE DAVIS (PMHNP) does?
Insurance directories may phrase it differently, but here CHARLENE DAVIS (PMHNP) maps to Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What geographic area is tied to CHARLENE DAVIS (PMHNP)?
CHARLENE DAVIS (PMHNP) is associated with Roseburg, Oregon in the same public data insurers reference.
Can I export CHARLENE DAVIS (PMHNP)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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