Active NPI
Robert J Gillespie, MD
- Pediatrics Physician
- Portland, OR
National Provider Identifier
1043209067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD22883
- Practice address
- 9555 SW Barnes Rd
Ste 301
Portland, OR 97225 - Phone
- (503) 297-3371
- Fax
- (503) 297-3371
- NPI assigned
- Oct 21, 2005
- 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 | MD22883 | OR | Primary |
Addresses
Primary practice location
9555 SW Barnes Rd
Ste 301
Portland, OR 97225
Mailing address
9555 SW Barnes Rd
Ste 301
Portland, OR 97225
Phone (503) 297-3371
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 228958 | Medicaid | OR |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD22883 | OR | MD | Pediatrics Physician |
Interoperability endpoints
- rgillespie11632@direct.lhs.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295913600000",
"number": "1043209067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9555 SW BARNES RD",
"address_2": "STE 301",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97225",
"telephone_number": "503-297-3371",
"fax_number": "503-297-3371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9555 SW BARNES RD",
"address_2": "STE 301",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97225",
"telephone_number": "503-297-3371",
"fax_number": "503-297-3371"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLESPIE",
"first_name": "ROBERT",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-21",
"last_updated": "2011-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OR",
"license": "MD22883",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "228958",
"state": "OR"
}
],
"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 Jan 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.