Active NPI
Ole Lloyd Anderson Ersson, MD
- Family Medicine Physician
- Portland, OR
National Provider Identifier
1194876763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD20494
- Practice address
- 426 SW Stark St
8TH Floor
Portland, OR 97204-2347 - Phone
- (503) 988-5033
- Fax
- (503) 988-5030
- NPI assigned
- Jan 12, 2007
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD20494 | OR | Primary |
Addresses
Primary practice location
426 SW Stark St
8TH Floor
Portland, OR 97204-2347
Mailing address
426 SW Stark St
8TH Floor
Portland, OR 97204-2347
Phone (503) 988-5033
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD20494 | OR | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233014400000",
"number": "1194876763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "426 SW STARK ST",
"address_2": "8TH FLOOR",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972042347",
"telephone_number": "503-988-5033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "426 SW STARK ST",
"address_2": "8TH FLOOR",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972042347",
"telephone_number": "503-988-5033",
"fax_number": "503-988-5030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERSSON",
"first_name": "OLE",
"middle_name": "LLOYD ANDERSON",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-12",
"last_updated": "2009-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD20494",
"primary": true
}
],
"identifiers": [],
"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 Jan 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.