Active NPI
James V. Sisk, MD
- Family Medicine Physician
- Seaside, OR
National Provider Identifier
1316088404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 97132
- Practice address
- 725 S Wahanna Rd
Seaside, OR 97138-7735 - Phone
- (503) 717-7247
- NPI assigned
- Feb 9, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 | 97132 | OR | Primary |
Addresses
Primary practice location
725 S Wahanna Rd
Seaside, OR 97138-7735
Mailing address
1218 SE Rex St
Portland, OR 97202-5940
Phone (503) 233-1675
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 |
|---|---|---|---|
| 97132 | OR | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1316088404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1218 SE REX ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972025940",
"telephone_number": "503-233-1675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 S WAHANNA RD",
"city": "SEASIDE",
"state": "OR",
"postal_code": "971387735",
"telephone_number": "503-717-7247"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SISK",
"first_name": "JAMES",
"middle_name": "V.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "97132",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seaside, 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.