Individual provider Active NPI

Collin Maurice McLaughlin, DO

  • Internal Medicine Physician
  • Keizer, OR
National Provider Identifier
1215220306
Registry record updated Oct 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO171491 Issued in OR
Practice address
5305 River Rd N Ste B
Keizer, OR 97303-5324
Phone
(412) 867-6899
NPI assigned
May 23, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2020

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34.014790 OH
Internal Medicine Physician 207R00000X 008763 AZ
Internal Medicine Physician 207R00000X TPOS68 FL
Internal Medicine Physician 207R00000X OS017030 PA
Internal Medicine Physician 207R00000X DO171491 OR Primary

Addresses

Primary practice location

5305 River Rd N Ste B
Keizer, OR 97303-5324

Mailing address

5305 River Rd N Ste B
Keizer, OR 97303-5324
Phone (412) 867-6899

Other practice location 1

2020 Capitol St NE
Salem, OR 97301-0644
Phone (503) 399-2424

Other identifiers 1

IdentifierTypeStateIssuer
500689379MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, MD, NC3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20150810002838 OR Practitioner - HospitalistPractitioner - Internal Medicine 2860618642 Reassigns benefits to 6 organizations
I20200729001034 MD Practitioner - Internal Medicine 2860618642 Reassigns benefits to 1 organization
I20201029000366 NC Practitioner - Internal Medicine 2860618642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

1015 NW 22ND Ave
Portland, OR 97210-3025
Phone (503) 413-7711

Hospital & facility affiliations

  • Legacy Emanuel Medical Center Hospital, Portland, OR, CCN 380007
  • Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
008763AZMDInternal Medicine Physician
TPOS68FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Clinics LLC CurrentSince Aug 19, 2021 Accepting new patients
Providence Health & Services - Oregon Internal Medicine Current Accepting new patients
Providence Health & Services - Oregon Family Medicine CurrentSince Apr 1, 2022 Accepting new patients
Legacy Clinics LLC Family Medicine CurrentSince Aug 19, 2021 Accepting new patients
Providence Health & Services - Oregon Family Medicine CurrentSince Apr 1, 2022 Accepting new patients
Providence Health & Services Oregon CurrentSince Apr 1, 2022 Accepting new patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Apr 1, 2022 Accepting new patients
Providence Health & Services Oregon Internal Medicine Current Accepting new patients
Providence Health & Services Oregon Family Medicine CurrentSince Apr 1, 2022 Accepting new patients
Providence Health & Services Oregon CurrentSince Apr 1, 2022 Accepting new patients
Post Acute Telehealth PC Family Medicine CurrentSince Mar 8, 2021 Accepting new patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Apr 1, 2022 Accepting new patients

Locations

14751 Carey Rd
Carmel, IN 46033
Phone (317) 575-2208

101 Potters Ln
Clarksville, IN 47129
Phone (812) 948-0808

2525 W Belvedere Ave
Baltimore, MD 21215
Phone (410) 367-9100

3000 North Ridge Rd
Ellicott City, MD 21043
Phone (410) 461-7577

105 Time Sq
Salisbury, MD 21801
Phone (410) 749-2474

1234 Washington Rd
Westminster, MD 21157
Phone (410) 848-0700

4700 Ashwood Dr
Ste 200
Blue Ash, OH 45241
Phone (800) 989-7337

625 Probasco St
Cincinnati, OH 45220
Phone (513) 281-0745

200 S Hazel Dell Way
Ste 210
Canby, OR 97013
Phone (503) 263-9550

1500 Division St
Oregon City, OR 97045
Phone (503) 646-1631

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

10150 SE 32nd Ave
Portland, OR 97222
Phone (503) 215-4202

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 13

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1306108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1215220306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5305 RIVER RD N STE B",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973035324",
            "telephone_number": "412-867-6899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5305 RIVER RD N STE B",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973035324",
            "telephone_number": "412-867-6899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2020 Capitol St NE",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973010644",
            "country_code": "US",
            "telephone_number": "503-399-2424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCLAUGHLIN",
        "first_name": "COLLIN",
        "middle_name": "MAURICE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-23",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34.014790",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "008763",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "TPOS68",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS017030",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "DO171491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500689379",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Keizer, OR

Sources for this page

Verify at the official NPI Registry.