Individual provider Active NPI

Thomas E. Pitchford III, MD

  • General Practice Physician
  • Port Orford, OR
National Provider Identifier
1164446589
Registry record updated Oct 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
MD15040 Issued in OR
Practice address
525 Madrona Avenue
Port Orford, OR 97465-9552
Phone
(541) 332-3861
Fax
(541) 332-0250
NPI assigned
Jul 27, 2006
Last updated
Oct 25, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X MD15040 OR Primary

Addresses

Primary practice location

525 Madrona Avenue
Port Orford, OR 97465-9552

Mailing address

94220 4TH St
Gold Beach, OR 97444-7756
Phone (541) 247-3000

Other identifiers 3

IdentifierTypeStateIssuer
113530MedicaidOR
1811939093OtherORCURRY FAMILY MEDICAL'S NPI
1487696985OtherORCURRY GENERAL HOSPITAL'S NPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050617000933 OR Practitioner - General Practice 4880638071 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Curry Health District CurrentSince Jul 8, 2010 Accepting new patients
Curry Health District CurrentSince Jul 8, 2010 Accepting new patients
Curry Health District Past Accepting new patients

Locations

500 5th St
Brookings, OR 97415
Phone (541) 412-2000

94220 4th St
Gold Beach, OR 97444
Phone (541) 247-3000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1164446589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94220 4TH ST",
            "city": "GOLD BEACH",
            "state": "OR",
            "postal_code": "974447756",
            "telephone_number": "541-247-3000",
            "fax_number": "541-247-3101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 MADRONA AVENUE",
            "city": "PORT ORFORD",
            "state": "OR",
            "postal_code": "974659552",
            "telephone_number": "541-332-3861",
            "fax_number": "541-332-0250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITCHFORD",
        "first_name": "THOMAS",
        "middle_name": "E.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2020-10-25",
        "certification_date": "2020-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OR",
            "license": "MD15040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113530",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CURRY FAMILY MEDICAL'S NPI",
            "identifier": "1811939093",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CURRY GENERAL HOSPITAL'S NPI",
            "identifier": "1487696985",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orford, OR

Sources for this page

Verify at the official NPI Registry.