Active NPI
Myles Nelligan
- Gastroenterology Physician
- Portland, OR
National Provider Identifier
1285563205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 201707486RN
- Practice address
- 1111 NE 99TH Ave Ste 302
Portland, OR 97220-9442 - Phone
- (503) 963-2707
- NPI assigned
- May 15, 2026
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 201707486RN | OR | Primary |
Addresses
Primary practice location
1111 NE 99TH Ave Ste 302
Portland, OR 97220-9442
Mailing address
1111 NE 99TH Ave Ste 302
Portland, OR 97220-9442
Phone (503) 963-2707
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
| License | State | Type | Specialty |
|---|---|---|---|
| 201707486RN | OR | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1778803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778803200000",
"number": "1285563205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 NE 99TH AVE STE 302",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972209442",
"telephone_number": "503-963-2707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 NE 99TH AVE STE 302",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972209442",
"telephone_number": "503-963-2707"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELLIGAN",
"first_name": "MYLES",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2026-05-15",
"last_updated": "2026-05-15",
"certification_date": "2026-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "OR",
"license": "201707486RN",
"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 May 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.