NPIMap

Organization Active NPI

Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Salem, OR
National Provider Identifier
1174075154
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
Practice address
5125 Skyline Rd S
Salem, OR 97306-9427
Phone
(800) 813-2000
Fax
(503) 240-3933
NPI assigned
Oct 26, 2016
Organization subpart
Yes
Parent organization
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWESTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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

Authorized official

Name
Stephen Shawn Barton
Title
Executive Director, Revenue Cycle
Phone
(503) 813-2440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

5125 Skyline Rd S
Salem, OR 97306-9427

Mailing address

500 NE Multnomah St
Portland, OR 97232-2023
Phone (800) 813-2000

Other names 1

  • Skyline Medical Office Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

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
38D0668653Kaiser Permanente Skyline Medical Office Lab5125 Skyline Rd South, Salem, OR 97306Provider-performed microscopyAug 19, 2027

National Provider Directory

National Provider Directory
Tax ID family
Permananet Clinic150 organizations share this tax ID, including this one
Part of
Permananet Clinic

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622505600000",
    "number": "1174075154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 NE MULTNOMAH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322023",
            "telephone_number": "800-813-2000",
            "fax_number": "503-286-6879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5125 SKYLINE RD S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973069427",
            "telephone_number": "800-813-2000",
            "fax_number": "503-240-3933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST",
        "enumeration_date": "2016-10-26",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A",
        "authorized_official_last_name": "BARTON",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "SHAWN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR, REVENUE CYCLE",
        "authorized_official_telephone_number": "503-813-2440"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5125 Skyline Rd S",
            "city": "Salem",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973069427",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Skyline Medical Office",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Skyline Medical Office",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.