Northwest Primary Care Group PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NORTHWEST PRIMARY CARE GROUP PC

Practice address

16144 SE Happy Valley Town Center Dr Ste 101
Happy Valley, OR 97086-4257

Phone

(503) 659-4988

Fax

(503) 698-4018

NPI assigned

Jul 21, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Michael Whitbeck

Title

Administrator

Phone

(503) 659-4777

Specialties & licenses 4

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Northwest Primary Care Group PC

  • Internal Medicine Physician
  • Milwaukie, OR
  • NPI 1083638589

  O20040219000947

  Same enrollment
• Northwest Primary Care Group PC

  • Family Medicine Physician
  • Portland, OR
  • NPI 1144319658

  O20040219000947

  Same enrollment
• Northwest Primary Care Group PC

  • Family Medicine Physician
  • Milwaukie, OR
  • NPI 1801856737

  O20040219000947

  Same enrollment
• Northwest Primary Care Group PC

  • Physical Medicine & Rehabilitation Physician
  • Portland, OR
  • NPI 1922028869

  O20040219000947

  Same enrollment
• Northwest Primary Care Group, PC

  • Family Medicine Physician
  • Milwaukie, OR
  • NPI 1558572180

  O20040219000947

  Same enrollment

Locations

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591142400000",
    "number": "1043230972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22075",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972692075",
            "telephone_number": "503-659-4777",
            "fax_number": "503-652-5223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16144 SE HAPPY VALLEY TOWN CENTER DR STE 101",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970864257",
            "telephone_number": "503-659-4988",
            "fax_number": "503-698-4018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST PRIMARY CARE GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A",
        "authorized_official_last_name": "WHITBECK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "503-659-4777",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "226666",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "38D0888269",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500620284",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD GROUP PTAN",
            "identifier": "CE8055",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lynn Marie Nishida, RPH
• Johnny Nolan, DO
• Northland Hearing Centers, Inc.
• Northwest Extremity Specialists LLC
• Northwest Primary Care Group PC
• Northwest Primary Care Group, PC
• Kevin E Nufer, MD
• Karla June Nussbaum, IBCLC
• NW Health & Wellness, LLC
• NW Spine & Health

• Family Medicine Physician in Happy Valley, OR
• Providers in Happy Valley, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.