NPIMap

Organization Active NPI

Jimmy Huebert MD Inc

  • Sports Medicine (Internal Medicine) Physician
  • Tualatin, OR
National Provider Identifier
1235307331
Registry record updated Jul 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0010X
License
23362 Issued in OR
Legal business name
JIMMY HUEBERT MD INC
Practice address
6464 SW Borland Rd Ste D2
Tualatin, OR 97062-8861
Phone
(503) 885-8008
Fax
(503) 885-8002
NPI assigned
Feb 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2009

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

Authorized official

Name
Mrs. Michelle Huebert
Title
Owner
Phone
(503) 885-8008

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RS0010X 23362 OR Primary

Addresses

Primary practice location

6464 SW Borland Rd Ste D2
Tualatin, OR 97062-8861

Mailing address

6464 SW Borland Rd Ste D2
Tualatin, OR 97062-8861
Phone (503) 885-8008

Other identifiers 1

IdentifierTypeStateIssuer
131294OtherORINDIVIDUAL MEDICARE PIN#

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1202774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247616000000",
    "number": "1235307331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6464 SW BORLAND RD STE D2",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628861",
            "telephone_number": "503-885-8008",
            "fax_number": "503-885-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6464 SW BORLAND RD STE D2",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628861",
            "telephone_number": "503-885-8008",
            "fax_number": "503-885-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIMMY HUEBERT MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-12",
        "last_updated": "2009-07-15",
        "status": "A",
        "authorized_official_last_name": "HUEBERT",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-885-8008",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RS0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "OR",
            "license": "23362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL MEDICARE PIN#",
            "identifier": "131294",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tualatin, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.

Verify at the official NPI Registry.