LIGHT SIDE WELLNESS CO.
NPI 1710660956
Nurse Practitioner - Psychiatric/Mental Health in Portland, OR
About Light Side Wellness Co. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LIGHT SIDE WELLNESS CO. (NPI 1710660956) is a healthcare organization registered as a psychiatric/mental health in Portland, Oregon and active in the NPI registry since August 2023. The organization lists Steven Jon Knott, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted 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)
Light Side Wellness Co. 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 Light Side Wellness Co., which bills Medicare for the services this clinician delivers.
Clinician (1)
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 Light Side Wellness Co.'s NPI number?
The NPI number for Light Side Wellness Co. is 1710660956. It was assigned to this organization in the NPPES registry on August 14, 2023.
Where is Light Side Wellness Co. located?
Light Side Wellness Co. is located at 2175 NW Raleigh St Ste 110, Portland, OR 97210. The listed phone number is (503) 773-4673.
What is Light Side Wellness Co.'s specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Light Side Wellness Co. enrolled in Medicare?
Yes. Light Side Wellness Co. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Light Side Wellness Co.?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Light Side Wellness Co.. 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 Light Side Wellness Co. accept?
Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and Regence BlueCross BlueShield of Oregon list Light Side Wellness Co. 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 Light Side Wellness Co. was last updated on August 14, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Light Side Wellness Co. · NPI 1710660956
Psychiatric/Mental Health organization in Portland, Oregon. Organization record, active in the CMS NPPES registry since August 14, 2023.
## Identity
- **NPI:** 1710660956 (Entity type: Organization)
- **Enumerated:** August 14, 2023
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Steven Knott, OWNER
## Practice location
- **Address:** 2175 NW RALEIGH ST STE 110, Portland, OR 97210-2392
- **Phone:** (503) 773-4673
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 14, 2023
---
Source: [NPI Profile](https://npiprofile.com/npi/1710660956) · Data from the CMS NPPES public registry.