Organization Active NPI

James W Baker MD LLC

  • Allergy & Immunology Physician
  • Portland, OR
National Provider Identifier
1225207178
Registry record updated Jul 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
MD08914 Issued in OR
Legal business name
JAMES W BAKER MD LLC
Practice address
9495 SW Locust St Ste a
Portland, OR 97223-6683
Phone
(503) 636-9011
Fax
(503) 636-3952
NPI assigned
Feb 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2015

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

Authorized official

Name
Cindy M Madden
Title
Administrator
Phone
(503) 505-5937

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X MD08914 OR
Allergy & Immunology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207K00000X MD08914 OR Primary
Allergy PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207KA0200X MD08914 OR
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X MD08916 OR

Addresses

Primary practice location

9495 SW Locust St Ste a
Portland, OR 97223-6683

Mailing address

9495 SW Locust St Ste a
Portland, OR 97223-6683
Phone (503) 636-9011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091006000619 OR Part B Supplier - Clinic/Group Practice 5597801456 Receives reassigned benefits from 5 practitioners
Practice locations: Portland, OR

National Provider Directory

National Provider Directory

Locations

3975 Mercantile Dr
#158
Lake Oswego, OR 97035
Phone (503) 636-9011

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1203897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438041600000",
    "number": "1225207178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9495 SW LOCUST ST STE A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972236683",
            "telephone_number": "503-636-9011",
            "fax_number": "503-636-3952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9495 SW LOCUST ST STE A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972236683",
            "telephone_number": "503-636-9011",
            "fax_number": "503-636-3952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES W BAKER MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-25",
        "last_updated": "2015-07-28",
        "status": "A",
        "authorized_official_last_name": "MADDEN",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "503-505-5937"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "OR",
            "license": "MD08914",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": "OR",
            "license": "MD08914",
            "primary": true
        },
        {
            "code": "207KA0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology, Allergy",
            "state": "OR",
            "license": "MD08914",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "OR",
            "license": "MD08916",
            "primary": false
        }
    ],
    "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 Jul 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.