Active NPI
Leila H. Keltner, MD
- Family Medicine Physician
- Portland, OR
National Provider Identifier
1316061609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD15806
- Practice address
- 2800 N Vancouver Ave
Suite 201
Portland, OR 97227-1630 - Phone
- (503) 331-2400
- Fax
- (503) 331-2410
- NPI assigned
- Mar 19, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD15806 | OR | Primary |
Addresses
Primary practice location
2800 N Vancouver Ave
Suite 201
Portland, OR 97227-1630
Mailing address
2800 N Vancouver Ave
Suite 201
Portland, OR 97227-1630
Phone (503) 331-2400
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 022546 | Medicaid | OR | |
| 8360463 | Medicaid | WA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD15806 | OR | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1316061609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2800 N VANCOUVER AVE",
"address_2": "SUITE 201",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972271630",
"telephone_number": "503-331-2400",
"fax_number": "503-331-2410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2800 N VANCOUVER AVE",
"address_2": "SUITE 201",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972271630",
"telephone_number": "503-331-2400",
"fax_number": "503-331-2410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELTNER",
"first_name": "LEILA",
"middle_name": "H.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD15806",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "022546",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8360463",
"state": "WA"
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.