CLARISSA EVANELL CARSON (PMHNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1205533155

CLARISSA EVANELL CARSON (PMHNP) is a healthcare provider. based in Medford, Oregon. specializing in NURSE PRACTITIONER. They hold the professional credentials PMHNP. They hold a License No. 10004386 (OR). The NPI Number for CLARISSA EVANELL CARSON (PMHNP) is 1205533155

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
CLARISSA EVANELL CARSON (PMHNP)
NPI
1205533155
Phone
(541) 842-7705
Address
900 E MAIN ST
Enumeration Date
10 February 2023
Last Update Date
13 April 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5417733863
Graduation Year
2022 (4 years ago)
PAC ID
6901270594
Group Practice PAC ID
1557266236
Professional Enrollment ID
I20230322001310
Address ID
OR975047337ME19XXXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness85
Years active:3State licenses:1Digital endpointsOther names

3,366 NURSE PRACTITIONER in OR

Provider Addresses for CLARISSA EVANELL CARSON (PMHNP)

  • 900 E MAIN ST

    MEDFORD, OR 975047136

    Phone: (541) 842-7705

    Fax: (541) 842-7640

    Type: Location

  • 1000 E MAIN ST

    MEDFORD, OR 975047667

    Phone: (541) 773-3863

    Fax: (541) 842-7640

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 10 Open Payments records for all available years, with a total value of $578.

Total Amount is formed as General ($578) + Research ($0) + Ownership ($0) = $578.

Last reported payment date: 2024-02-23 • Largest payer in this snapshot: Otsuka America Pharmaceutical, Inc. ($283).

Total Amount

$578

General + Research + Ownership

Payments

10

Total payment records

General Amount

$578

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-02-23

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2023-03-22

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
I20230322001310INurse 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 97504)

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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: 1557266236View full group profile
NameSpecialtyState
Family PracticeOR
Family PracticeOR
Mental Health CounselorOR
Family PracticeOR
Registered Dietitian Or Nutrition ProfessionalOR
Family PracticeOR
Osteopathic Manipulative MedicineOR
-VA
Mental Health CounselorOR
Clinical Social WorkerOR

Reviews

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Frequently asked questions

Does CLARISSA EVANELL CARSON (PMHNP) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — CLARISSA EVANELL CARSON (PMHNP) uses 1205533155.
Is CLARISSA EVANELL CARSON (PMHNP) listed as active for patients and plans?
The listing shows CLARISSA EVANELL CARSON (PMHNP) as active in the NPI system.
What taxonomy line describes CLARISSA EVANELL CARSON (PMHNP)?
For research purposes, treat CLARISSA EVANELL CARSON (PMHNP) as Psychiatric/Mental Health Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect CLARISSA EVANELL CARSON (PMHNP) on a map?
Expect Medford, Oregon as a primary anchor for CLARISSA EVANELL CARSON (PMHNP) unless the record lists multiple sites.
Is the information about CLARISSA EVANELL CARSON (PMHNP) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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