Kenneth Paul Melvin, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD 24232 Issued in OR

Practice address

4035 Mercantile Dr
Suite 112
Lake Oswego, OR 97035-2546

Phone

(503) 203-1177

Fax

(503) 203-1178

NPI assigned

Apr 17, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kenneth P Melvin, MD, PC

  • Primary Care Clinic/Center
  • Lake Oswego, OR
  • NPI 1255501698
  Authorized official Same address or phone
• Uptown Providers Inc

  dba AFC Urgent Care

  • Urgent Care Clinic/Center
  • Portland, OR
  • NPI 1134563620
  NPD (past)
• Uptown Providers PC

  • General Practice Physician
  • Portland, OR
  • NPI 1144598293
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1013971837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6975 SW SANDBURG ST",
            "address_2": "SUITE 190",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972238073",
            "telephone_number": "503-639-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4035 MERCANTILE DR",
            "address_2": "SUITE 112",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970352546",
            "telephone_number": "503-203-1177",
            "fax_number": "503-203-1178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELVIN",
        "first_name": "KENNETH",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD 24232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corina Medina
• Medstar Inc
• Medstar NW, LLC
• Carolyn R Meisner, PT, DPT
• Theresa L Mele, RN
• Anne Waterman Meneakis, LCSW
• Sarah Jean Menezes
• Mental Health NW LLC
• Chanel Mercado, CCC-SLP
• Juliana Mercer

• Internal Medicine Physician in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.