Family Walk in Medical Center, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FAMILY WALK IN MEDICAL CENTER, PC

Practice address

15280 NW Central Dr
Suite 204
Portland, OR 97229

Phone

(503) 531-3858

Fax

(503) 645-1110

NPI assigned

May 15, 2008

Last updated

Mar 22, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Shagufta Hasan, MDNPI 1033296538

Title

Medical Director

Phone

(503) 531-3858

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/3710/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shagufta A Hasan, M.D.

  • Primary Care Clinic/Center
  • Portland, OR
  • NPI 1033296538
  Authorized official Same address or phone

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458604800000",
    "number": "1194992305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15280 NW CENTRAL DR",
            "address_2": "SUITE 204",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97229",
            "telephone_number": "503-531-3858",
            "fax_number": "503-645-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15280 NW CENTRAL DR",
            "address_2": "SUITE 204",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97229",
            "telephone_number": "503-531-3858",
            "fax_number": "503-645-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY WALK IN MEDICAL CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2016-03-22",
        "status": "A",
        "authorized_official_last_name": "HASAN",
        "authorized_official_first_name": "SHAGUFTA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "503-531-3858",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287934",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Family Healthpartners, LLC
• Family Medical Group Northeast, P.C.
• Family Practice Clinic LLC (Family Practice Clinic)
• Family Skillbuilders, Inc.
• Family Ties Counseling Center
• Familycare Inc.
• Famiy Roots Chiropractic
• Emily Fan, MD
• Guang Fan, MD
• Jessie Fan, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2016; 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.