Organization Active NPI

Pacific Family Medicine LLP

  • Family Medicine Physician
  • Astoria, OR
National Provider Identifier
1124070701
Registry record updated Jan 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PACIFIC FAMILY MEDICINE LLP
Practice address
2055 Exchange St
Ste 190
Astoria, OR 97103-3419
Phone
(503) 325-5300
Fax
(503) 325-5400
NPI assigned
May 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2010

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

Authorized official

Name
Dr. Katherine Merrill, MD
Title
Partner
Phone
(503) 325-5300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2055 Exchange St
Ste 190
Astoria, OR 97103-3419

Mailing address

2055 Exchange St
Ste 190
Astoria, OR 97103-3419
Phone (503) 325-5300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040817001457 OR Part B Supplier - Clinic/Group Practice 6406829407 Receives reassigned benefits from 2 practitioners
Practice locations: Astoria, OR

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D0991281Pacific Family Medicine2055 Exchange St #190, Astoria, OR 97103Provider-performed microscopySep 16, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264723200000",
    "number": "1124070701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 EXCHANGE ST",
            "address_2": "STE 190",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971033419",
            "telephone_number": "503-325-5300",
            "fax_number": "503-325-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 EXCHANGE ST",
            "address_2": "STE 190",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971033419",
            "telephone_number": "503-325-5300",
            "fax_number": "503-325-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC FAMILY MEDICINE LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2010-01-29",
        "status": "A",
        "authorized_official_last_name": "MERRILL",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "503-325-5300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.