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FUNCTIONAL MENTAL HEALTH LLC
NPI 1154944536
Nurse Practitioner - Psychiatric/Mental Health in Winston, OR

Active since May 20, 2020
11 SW BRANTLEY DR, WINSTON, OR 97496(541) 679-0366(541) 679-4821 Get Directions Write a Review

NPPES record last updated: January 27, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 27, 2021, May 20, 2020 (2 updates tracked since 2020).

About Functional Mental Health Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FUNCTIONAL MENTAL HEALTH LLC (NPI 1154944536) is a healthcare organization registered as a psychiatric/mental health in Winston, Oregon and active in the NPI registry since May 2020. The organization lists Mckenzie Smith, Pmhnp, as its authorized official.

NPPES Registry Identity

NPI1154944536
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameFUNCTIONAL MENTAL HEALTH LLC
Location Address11 SW BRANTLEY DRWinston, OR 97496-4526
Mailing Address11 Sw Brantley DrWinston, OR 97496-4526 · (541) 679-0366 · Fax (541) 679-4821
Phone(541) 679-0366
Fax(541) 679-4821
Organization SubpartNo
Authorized OfficialMckenzie SmithPmhnp · (541) 326-8078
Enumeration DateMay 20, 2020
Last NPPES UpdateJanuary 27, 20212 updates tracked since enumeration
NPPES CertifiedJanuary 14, 2021
✔ NPI 1154944536 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
11 SW BRANTLEY DR, Winston, OR 97496
Open in Google Maps ↗

Other Names 1

Doing Business AsFunctional Mental Health Llc

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., Regence BlueCross BlueShield of Oregon.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Functional Mental Health Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Functional Mental Health LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Mckenzie Smith
Nurse Practitioner
NPI 1932551165
121 NE A ST
Grants Pass, OR 97526
(541) 835-8435
✔ PECOS✔ Accepts Medicare48 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Functional Mental Health LLC's NPI number?

The NPI number for Functional Mental Health LLC is 1154944536. It was assigned to this organization in the NPPES registry on May 20, 2020.

Where is Functional Mental Health LLC located?

Functional Mental Health LLC is located at 11 SW Brantley Dr, Winston, OR 97496. The listed phone number is (541) 679-0366.

What is Functional Mental Health LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Functional Mental Health LLC enrolled in Medicare?

Yes. Functional Mental Health LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Functional Mental Health LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Functional Mental Health LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Functional Mental Health LLC accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc. and Regence BlueCross BlueShield of Oregon list Functional Mental Health LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Functional Mental Health LLC was last updated on January 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.