Internal Medicine Associates of Portland, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD08175 Issued in OR

Legal business name

INTERNAL MEDICINE ASSOCIATES OF PORTLAND, LLC

Practice address

10373 NE Hancock St
Suite 115
Portland, OR 97220-3873

Phone

(503) 853-8631

Fax

(503) 853-8636

NPI assigned

Sep 25, 2007

Organization subpart

No

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

Authorized official

Name

Dr. F. William Miller, M.D.NPI 1881759983

Title

Owner

Phone

(503) 853-8631

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• F. William Miller, M.D.

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1881759983
  NPD (past) Authorized official
• Thomas Robert Dunham, M.D.

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1568527018
  NPD (past)
• Nora Lou Fairley, MD

  • Psychiatry Physician
  • Portland, OR
  • NPI 1861481285
  NPD (past)

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199404800000",
    "number": "1174710990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10373 NE HANCOCK ST",
            "address_2": "SUITE 115",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972203873",
            "telephone_number": "503-853-8631",
            "fax_number": "503-853-8636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10373 NE HANCOCK ST",
            "address_2": "SUITE 115",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972203873",
            "telephone_number": "503-853-8631",
            "fax_number": "503-853-8636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE ASSOCIATES OF PORTLAND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-25",
        "last_updated": "2008-01-04",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "F.",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-853-8631",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD08175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "139365",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Integrity Health Incorporated
• Intercultual Psychiatric Progam
• Interim Healthcare of Oregon, Inc.
• Internal Medicine Consultants, P.C.
• Internal Medicine of Oregon, LLC
• Internal Medicine Specialists, LLC
• Interpersonal Growth Organization, LLC
• Interstate Medical Group LLC

• Internal Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.