Active NPI
Thomas Craig Calverley, M.D.
- Emergency Medicine Physician
- Portland, OR
National Provider Identifier
1174611222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- MD15621
- Practice address
- 9205 SW Barnes Rd
Portland, OR 97225-6603 - Phone
- (550) 329-7633
- Fax
- (503) 297-2360
- NPI assigned
- Oct 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | MD15621 | OR | Primary |
Addresses
Primary practice location
9205 SW Barnes Rd
Portland, OR 97225-6603
Mailing address
9340 SW Barnes Rd
Suite 202
Portland, OR 97225-6623
Phone (503) 297-6334
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 042007 | Medicaid | OR | |
| 010053149 | Other | OR | UNITED HEALTHCARE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tcalverley101614@oc.providencedirect.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD15621 | OR | MD | Emergency Medicine Physician |
Interoperability endpoints
- tcalverley101614@oc.providencedirect.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600992000000",
"number": "1174611222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9340 SW BARNES RD",
"address_2": "SUITE 202",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972256623",
"telephone_number": "503-297-6334",
"fax_number": "503-297-2360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9205 SW BARNES RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972256603",
"telephone_number": "550-329-7633",
"fax_number": "503-297-2360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALVERLEY",
"first_name": "THOMAS",
"middle_name": "CRAIG",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-11",
"last_updated": "2020-09-25",
"certification_date": "2020-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "OR",
"license": "MD15621",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "042007",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "010053149",
"state": "OR"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tcalverley101614@oc.providencedirect.org",
"affiliation": "N",
"address_1": "9340 SW Barnes Rd",
"city": "Portland",
"state": "OR",
"country_code": "US",
"postal_code": "972256623",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}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 Sep 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.