LACEY EVANS (APRN) – Psychiatric/Mental Health Nurse Practitioner, NPI 1609333632
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,366 NURSE PRACTITIONER in OR
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Provider Addresses for LACEY EVANS (APRN)
Columbia Care Services, 3587, Heathrow Way, Medford, Jackson County, Oregon, 97502, United States
MEDFORD, OR 975044004
Phone: (541) 858-8170
Fax: (541) 858-8167
Type: Mailing
Westgate, Pendleton, Umatilla County, Oregon, 97801, United States
PENDLETON, OR 978019613
Phone: (541) 429-8721
Fax: (541) 429-8720
Type: Location
12636 SE STARK ST BLDG J
PORTLAND, OR 972331058
Phone: (503) 253-4600
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2026-01-28
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20231018003991 | I | Nurse Practitioner | OR | TBD |
| I20250206001889 | I | Nurse Practitioner | WA | TBD |
| I20260128000980 | I | Nurse Practitioner | IL | TBD |
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.
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
| Name | Specialty | State |
|---|---|---|
| Clinical Psychologist | VA | |
| - | PA | |
| Nurse Practitioner | IL | |
| - | AZ | |
| Nurse Practitioner | IL | |
| - | KS | |
| - | MD | |
| Nurse Practitioner | OK | |
| Nurse Practitioner | MO | |
| - | KS |
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