Individual provider Active NPI

Christopher Peter McCarthy, LD

  • Denturist
  • Portland, OR
National Provider Identifier
1255997235
Registry record updated Feb 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DenturistTaxonomy code 122400000X
License
DT-DO-10198679 Issued in OR
Practice address
200 NE 20TH Ave Ste 100
Portland, OR 97232-3094
Phone
(503) 230-0207
NPI assigned
May 15, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Denturist 122400000X DT-DO-10198679 OR Primary

Addresses

Primary practice location

200 NE 20TH Ave Ste 100
Portland, OR 97232-3094

Mailing address

200 NE 20TH Ave Ste 100
Portland, OR 97232-3094
Phone (503) 230-0207

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DT-DO-10198679ORMDDenturist

Practice roles

OrganizationSpecialtyStatusNew patients
First Impressions Denture Studio Denturist CurrentSince Sep 23, 2021 Accepting new patients

Locations

200 NE 20th Ave
Ste 100
Portland, OR 97232
Phone (503) 230-0207

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1557878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1255997235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NE 20TH AVE STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972323094",
            "telephone_number": "503-230-0207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NE 20TH AVE STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972323094",
            "telephone_number": "503-230-0207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTHY",
        "first_name": "CHRISTOPHER",
        "middle_name": "PETER",
        "name_prefix": "Mr.",
        "credential": "LD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-15",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122400000X",
            "taxonomy_group": "",
            "desc": "Denturist",
            "state": "OR",
            "license": "DT-DO-10198679",
            "primary": true
        }
    ],
    "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 Feb 25, 2022; 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.