Active NPI
Rodica Malos, DOCTOR OF NURSING PR
- Nurse Practitioner
- Portland, OR
National Provider Identifier
1063710754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 200150094NP
- Practice address
- 11020 NE Halsey Street
Portland, OR 97220 - Phone
- (503) 252-8500
- NPI assigned
- Mar 4, 2011
- Last updated
- Mar 4, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 200150094NP | OR | Primary |
Addresses
Primary practice location
11020 NE Halsey Street
Portland, OR 97220
Mailing address
7430 SE Division St
Portland, OR 97206
Phone (503) 771-8058
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
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299196800000",
"number": "1063710754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7430 SE DIVISION ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97206",
"telephone_number": "503-771-8058",
"fax_number": "503-771-8058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11020 NE HALSEY STREET",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97220",
"telephone_number": "503-252-8500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALOS",
"first_name": "RODICA",
"credential": "DOCTOR OF NURSING PR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-03-04",
"last_updated": "2011-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OR",
"license": "200150094NP",
"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 Mar 4, 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.