Individual provider Active NPI

James E McDonald, FNP

  • Family Nurse Practitioner
  • Portland, OR
National Provider Identifier
1265513675
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
000033039N1 FNP-PP Issued in OR
Practice address
619 NW 6TH Ave FL 3
Portland, OR 97209-3964
Phone
(503) 988-5020
Fax
(503) 988-5022
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP30007095 WA
Family Nurse Practitioner 363LF0000X 000033039N1 FNP-PP OR Primary

Addresses

Primary practice location

619 NW 6TH Ave FL 3
Portland, OR 97209-3964

Mailing address

619 NW 6TH Ave FL 5
Portland, OR 97209-3964

Other identifiers 1

IdentifierTypeStateIssuer
23957-4MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071218000084 OR Practitioner - Nurse Practitioner 1759471584 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
000033039N1 FNP-PPORMDFamily Nurse Practitioner
AP30007095WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Multnomah County CurrentSince Sep 18, 2018 Accepting new patients
Multnomah County Current Accepting new patients

Locations

600 NE 8th St
Gresham, OR 97030
Phone (503) 988-4900

619 NW 6th Ave
Fl 3
Portland, OR 97209
Phone (503) 988-5020

619 NW 6th Ave
Fl 5
Portland, OR 97209
Phone (503) 988-3674

Interoperability endpoints

  • Direct secure messaging: jmcdonald1546@direct.ochin.org

Organizations & group practices 2

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1265513675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 NW 6TH AVE FL 5",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 NW 6TH AVE FL 3",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093964",
            "telephone_number": "503-988-5020",
            "fax_number": "503-988-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "JAMES",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30007095",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "000033039N1 FNP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23957-4",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.