Kenneth P Melvin, MD, PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

MD24232 Issued in OR

Legal business name

KENNETH P MELVIN, MD, PC

Practice address

4035 Mercantile Dr
Suite 112
Lake Oswego, OR 97035-2546

Phone

(503) 203-1177

Fax

(503) 203-1178

NPI assigned

Feb 29, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Paul Melvin, MD

Title

President

Phone

(503) 203-1177

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1204243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204243200000",
    "number": "1255501698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4035 MERCANTILE DR",
            "address_2": "SUITE 112",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970352546",
            "telephone_number": "503-203-1177",
            "fax_number": "503-203-1178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4035 MERCANTILE DR",
            "address_2": "SUITE 112",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970352546",
            "telephone_number": "503-203-1177",
            "fax_number": "503-203-1178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH P MELVIN, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-29",
        "last_updated": "2008-02-29",
        "status": "A",
        "authorized_official_last_name": "MELVIN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-203-1177",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OR",
            "license": "MD24232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON LICENSE",
            "identifier": "MD24232",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laurie Lee Kelly, RDH
• Melinda Kelly, LMT
• Neal N Kelly, RPH
• Kendra J. Summers, PHD
• Kennedy Chiropractic PC
• Stephen Kessler
• Samuel Kibani
• Megan B Kieres, LMT
• Peter Jonathan Kiessling, M.D.
• Alison Jane Kilcup, MD

• Primary Care Clinic/Center in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Primary Care Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 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.

Verify at the official NPI Registry.