Organization Active NPI

Phoebe Rich, MD LLC

  • Specialist
  • Portland, OR
National Provider Identifier
1124199484
Registry record updated Mar 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD14488 Issued in OR
Legal business name
PHOEBE RICH, MD LLC
Practice address
2565 NW Lovejoy St Ste 200
Portland, OR 97210-2996
Phone
(503) 226-3376
Fax
(503) 223-9561
NPI assigned
Nov 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2008

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

Authorized official

Name
Dr. Phoebe Rich, MDNPI 1205818101
Title
Owner
Phone
(503) 226-3376

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X MD14488 OR Primary

Addresses

Primary practice location

2565 NW Lovejoy St Ste 200
Portland, OR 97210-2996

Mailing address

2565 NW Lovejoy St Ste 200
Portland, OR 97210-2996
Phone (503) 226-3376

Other names 1

  • Oregon Dermatology and Research Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040324000225 OR Part B Supplier - Clinic/Group Practice 5597656983 Receives reassigned benefits from 7 practitioners
Practice locations: Portland, OR

National Provider Directory

National Provider Directory

Locations

2565 NW Lovejoy St
Ste 200
Portland, OR 97210
Phone (503) 226-3376

2222 NW Lovejoy St
Ste 419
Portland, OR 97210
Phone (503) 223-1933

Practitioners & affiliated clinicians

Practitioners 8

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": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205193600000",
    "number": "1124199484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2565 NW LOVEJOY ST STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102996",
            "telephone_number": "503-226-3376",
            "fax_number": "503-223-9561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2565 NW LOVEJOY ST STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102996",
            "telephone_number": "503-226-3376",
            "fax_number": "503-223-9561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOEBE RICH, MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-10",
        "last_updated": "2008-03-11",
        "status": "A",
        "authorized_official_last_name": "RICH",
        "authorized_official_first_name": "PHOEBE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-226-3376",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OR",
            "license": "MD14488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oregon Dermatology and Research Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.