Active NPI
Joel A. Amundson, M.D.
- Pediatrics Physician
- Portland, OR
National Provider Identifier
1013972090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD26852
- Practice address
- 5231 NE Martin Luther King Jr Blvd
Portland, OR 97211-3235 - Phone
- (503) 342-2180
- NPI assigned
- Apr 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD26852 | OR | Primary |
Addresses
Primary practice location
5231 NE Martin Luther King Jr Blvd
Portland, OR 97211-3235
Mailing address
5231 NE Martin Luther King Jr Blvd
Portland, OR 97211-3235
Phone (503) 342-2180
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- joel@trailheadpediatrics.opdirect.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523491200000",
"number": "1013972090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5231 NE MARTIN LUTHER KING JR BLVD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972113235",
"telephone_number": "503-342-2180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5231 NE MARTIN LUTHER KING JR BLVD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972113235",
"telephone_number": "503-342-2180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMUNDSON",
"first_name": "JOEL",
"middle_name": "A.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-20",
"last_updated": "2018-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OR",
"license": "MD26852",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.