Organization Active NPI

Marcia Kerensky, MD

  • Alzheimer Center (Dementia Center)
  • Portland, OR
National Provider Identifier
1083012108
Registry record updated Dec 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Alzheimer Center (Dementia Center)Taxonomy code 311500000X
License
16947 Issued in OR
Legal business name
MARCIA KERENSKY, MD
Practice address
1804 SW Pendleton St
Portland, OR 97239-2050
Phone
(503) 715-6437
NPI assigned
Dec 6, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2014

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

Authorized official

Name
Dr. Marcia Margaret Kerensky, MDNPI 1053311670
Title
Physician
Phone
(503) 715-6437

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Alzheimer Center (Dementia Center) 311500000X 16947 OR Primary

Addresses

Primary practice location

1804 SW Pendleton St
Portland, OR 97239-2050

Mailing address

1804 SW Pendleton St
Portland, OR 97239-2050
Phone (503) 715-6437

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1417824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417824000000",
    "number": "1083012108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 SW PENDLETON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972392050",
            "telephone_number": "503-715-6437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 SW PENDLETON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972392050",
            "telephone_number": "503-715-6437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARCIA KERENSKY, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-06",
        "last_updated": "2014-12-06",
        "status": "A",
        "authorized_official_last_name": "KERENSKY",
        "authorized_official_first_name": "MARCIA",
        "authorized_official_middle_name": "MARGARET",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "503-715-6437",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "OR",
            "license": "16947",
            "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 Dec 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.