Active NPI
David Shute, MD
- Internal Medicine Physician
- Portland, OR
National Provider Identifier
1174690572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD14517
- Practice address
- 9450 SW Barnes Rd
Suite 100
Portland, OR 97225-6619 - Phone
- (503) 292-9560
- Fax
- (503) 292-9510
- NPI assigned
- Nov 29, 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD14517 | OR | Primary |
Addresses
Primary practice location
9450 SW Barnes Rd
Suite 100
Portland, OR 97225-6619
Mailing address
9450 SW Barnes Rd
Suite 100
Portland, OR 97225-6619
Phone (503) 292-9560
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 810029008 | Other | OR | REGENCE BLUE CROSS |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337904000000",
"number": "1174690572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9450 SW BARNES RD",
"address_2": "SUITE 100",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972256619",
"telephone_number": "503-292-9560",
"fax_number": "503-292-9510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9450 SW BARNES RD",
"address_2": "SUITE 100",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972256619",
"telephone_number": "503-292-9560",
"fax_number": "503-292-9510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHUTE",
"first_name": "DAVID",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-29",
"last_updated": "2012-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OR",
"license": "MD14517",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE CROSS",
"identifier": "810029008",
"state": "OR"
}
],
"endpoints": [],
"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 May 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.