Active NPI
Gilbert C Child, MD
- Ophthalmology Physician
- Portland, OR
National Provider Identifier
1205838877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- MD11128
- Practice address
- 9155 SW Barnes Rd
336
Portland, OR 97225-6625 - Phone
- (503) 292-0848
- Fax
- (503) 296-0635
- NPI assigned
- Aug 12, 2005
- 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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | MD11128 | OR | Primary |
Addresses
Primary practice location
9155 SW Barnes Rd
336
Portland, OR 97225-6625
Mailing address
6420 SW Macadam Ave
Suite 216
Portland, OR 97239-3507
Phone (503) 244-8601
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 066159 | Medicaid | OR | |
| 180015176 | Other | OR | RAILROAD MEDICARE |
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 |
|---|---|---|---|
| MD11128 | OR | MD | Ophthalmology Physician |
| 11128 | OR | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oregon Eye Specialists, PC | Past | Accepting new patients | |
| Oregon Eye Specialists PC | Ophthalmology | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211932800000",
"number": "1205838877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6420 SW MACADAM AVE",
"address_2": "SUITE 216",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972393507",
"telephone_number": "503-244-8601",
"fax_number": "503-244-8738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9155 SW BARNES RD",
"address_2": "336",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972256625",
"telephone_number": "503-292-0848",
"fax_number": "503-296-0635"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHILD",
"first_name": "GILBERT",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-12",
"last_updated": "2008-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "OR",
"license": "MD11128",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "066159",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "180015176",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
- Christopher V Chien, M.D.
- Grace Chien, M.D.
- Chienku Supply Corporation
- Komala Chigatere
- Tanis Yat-Kai Chik, L.AC., L.M.T.
- David Courtland Childers, MD
- Michelle Childers, PWS, THW
- Jana Marie Childes, MS, CCC-SLP
- Children's Community Clinic
- Children's Developmental Health Institute (Hearing Institute)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.