Axis Psychiatric Services LLC – Psychiatry Physician, NPI 1457845182

Axis Psychiatric Services LLC is a healthcare provider. based in Salem, Oregon. specializing in Psychiatry Physician. The organization holds a License No. 201701173NP-PP (OR). The NPI Number for Axis Psychiatric Services LLC is 1457845182

Main info

Organization
Name
Axis Psychiatric Services LLC
NPI
1457845182
Phone
(615) 243-5407
Address
PO BOX 12926
Authorized Official
TARRA LEANI BAKER PSYCHIATRIC NURSE PRACTITIONER MSN, PMHNP, NP
Enumeration Date
16 June 2018
Last Update Date
5 January 2021

Contacts

Main Contact
-
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness90
Years active:7State licenses:1Updated within 12 months

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Provider Addresses for Axis Psychiatric Services LLC

  • PO BOX 12926

    SALEM, OR 973090926

    Phone: (615) 243-5407

    Type: Mailing

  • 1249, Fairview Avenue Southeast, Salem, Marion County, Oregon, 97302, United States

    SALEM, OR 973022534

    Phone: (971) 239-1146

    Fax: (503) 371-2006

    Type: Location

  • 4035 12TH ST CUT OFF SE STE 140

    SALEM, OR 973021754

    Phone: (971) 304-9306

    Fax: (503) 371-2006

    Type: Location

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: 2018-10-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-10-31 (587 days ago).

Enrollment records

1

Earliest due date

2024-10-31

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
O20181009002379OClinic/Group PracticeOR2024-10-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

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 97309)

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Reviews

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Frequently asked questions

What federal number belongs to Axis Psychiatric Services LLC?
The federal identifier for Axis Psychiatric Services LLC is NPI 1457845182.
Is Axis Psychiatric Services LLC's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does Axis Psychiatric Services LLC list a primary specialty?
If you are matching referrals, note Psychiatry Physician for Axis Psychiatric Services LLC. Clinical services aligned with this taxonomy classification.
What location shows for Axis Psychiatric Services LLC?
We surface Salem, Oregon for Axis Psychiatric Services LLC based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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