Active NPI
Susan McCall, MD
- Public Health & General Preventive Medicine Physician
- Tualatin, OR
National Provider Identifier
1073745790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health & General Preventive Medicine Physician
- License
- MD19617
- Practice address
- 22260 SW 102ND PL
Tualatin, OR 97062-7199 - Phone
- (503) 330-6627
- NPI assigned
- Aug 13, 2009
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health & General Preventive Medicine Physician | 2083P0901X | MD19617 | OR | Primary |
| Legal Medicine (M.D./D.O.) Physician | 209800000X | MD19617 | OR |
Addresses
Primary practice location
22260 SW 102ND PL
Tualatin, OR 97062-7199
Mailing address
22260 SW 102ND PL
Tualatin, OR 97062-7199
Phone (503) 330-6627
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 |
|---|---|---|---|
| MD19617 | OR | MD | Legal Medicine (M.D./D.O.) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250121600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250121600000",
"number": "1073745790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22260 SW 102ND PL",
"city": "TUALATIN",
"state": "OR",
"postal_code": "970627199",
"telephone_number": "503-330-6627"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22260 SW 102ND PL",
"city": "TUALATIN",
"state": "OR",
"postal_code": "970627199",
"telephone_number": "503-330-6627"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCALL",
"first_name": "SUSAN",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-08-13",
"last_updated": "2009-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0901X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "OR",
"license": "MD19617",
"primary": true
},
{
"code": "209800000X",
"taxonomy_group": "",
"desc": "Legal Medicine",
"state": "OR",
"license": "MD19617",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tualatin, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.