Lake Oswego Family Physicians

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO14260 Issued in OR

Legal business name

LAKE OSWEGO FAMILY PHYSICIANS

Practice address

4035 Mercantile Dr
Suite 104
Lake Oswego, OR 97035-2546

Phone

(503) 635-1350

Fax

(503) 635-8470

NPI assigned

Jul 2, 2008

Organization subpart

No

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

Authorized official

Name

Debbie Selby

Title

Clinic Owner

Phone

(503) 635-1350

Specialties & licenses 1

Addresses

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/5525/brand/1/csg/1/fhir/r4

Practitioners 1

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

• Karl Nicholas Kaluza, D.O.

  • Sports Medicine (Family Medicine) Physician
  • Lake Oswego, OR
  • NPI 1760431175
  NPD (past)

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1093978835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4035 MERCANTILE DR",
            "address_2": "SUITE 104",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970352546",
            "telephone_number": "503-635-1350",
            "fax_number": "503-635-8470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4035 MERCANTILE DR",
            "address_2": "SUITE 104",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970352546",
            "telephone_number": "503-635-1350",
            "fax_number": "503-635-8470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE OSWEGO FAMILY PHYSICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-02",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "SELBY",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "CLINIC OWNER",
        "authorized_official_telephone_number": "503-635-1350"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO14260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake Grove Family Medical Clinic LLC
• Lake Grove Wellness
• Lake Medical Clinic, Inc.
• Lake Oswego Chiropractic Clinic, P.C.
• Lake Oswego Dermatology Group, PC
• Lake Oswego Foot Clinic
• Lake Oswego Health Center
• Lake Oswego Health Center
• Lake Oswego Massage Therapy
• Lake Oswego Modern Dentistry, PC

• Family Medicine Physician in Lake Oswego, OR
• Providers in Lake Oswego, 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 Jul 2, 2008; 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.