Individual provider Active NPI

Matthew R McMullin

  • Case Management Agency
  • McMinnville, OR
National Provider Identifier
1043123466
Registry record updated Sep 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Practice address
625 NE Galloway St
McMinnville, OR 97128-3933
Phone
(775) 790-1548
NPI assigned
Sep 25, 2026
Last updated
Sep 25, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X OR Primary

Addresses

Primary practice location

625 NE Galloway St
McMinnville, OR 97128-3933

Mailing address

2211 SW 1St Ave Unit 206
Portland, OR 97201-5012
Phone (775) 790-1548

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790294400000",
    "number": "1043123466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 SW 1ST AVE UNIT 206",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972015012",
            "telephone_number": "775-790-1548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 NE GALLOWAY ST",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971283933",
            "telephone_number": "775-790-1548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMULLIN",
        "first_name": "MATTHEW",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-09-25",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McMinnville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.