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

Last updated

Feb 29, 2008By the provider in NPPES

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, MDNPI 1013971837

Title

President

Phone

(503) 203-1177

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth Paul Melvin, MD

  • Internal Medicine Physician
  • Lake Oswego, OR
  • NPI 1013971837
  Authorized official Same address or phone

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": [],
    "endpoints": [],
    "other_names": []
}

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

• 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.