Organization Active NPI

Donald W Froom Mdllc

  • Specialist
  • Portland, OR
National Provider Identifier
1326079062
Registry record updated Feb 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MDO6973 Issued in OR
Legal business name
DONALD W FROOM MDLLC
Practice address
9155 SW Barnes Rd
Ste 534
Portland, OR 97225-6625
Phone
(503) 292-7721
Fax
(503) 292-6455
NPI assigned
Jul 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2008

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

Authorized official

Name
Donald Woodrow Froom, MD
Title
LLC
Phone
(503) 292-7721

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X MDO6973 OR Primary

Addresses

Primary practice location

9155 SW Barnes Rd
Ste 534
Portland, OR 97225-6625

Mailing address

9155 SW Barnes Rd
Ste 534
Portland, OR 97225-6625
Phone (503) 292-7721

Other identifiers 1

IdentifierTypeStateIssuer
061861MedicaidOR

Other names 1

  • Donald W Froom MDPC Former legal business name

National Provider Directory

National Provider Directory

Locations

9155 SW Barnes Rd
Ste 534
Portland, OR 97225
Phone (503) 292-7721

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203984000000",
    "number": "1326079062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9155 SW BARNES RD",
            "address_2": "STE 534",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256625",
            "telephone_number": "503-292-7721",
            "fax_number": "503-292-6455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9155 SW BARNES RD",
            "address_2": "STE 534",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256625",
            "telephone_number": "503-292-7721",
            "fax_number": "503-292-6455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONALD W FROOM MDLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2008-02-26",
        "status": "A",
        "authorized_official_last_name": "FROOM",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "WOODROW",
        "authorized_official_title_or_position": "LLC",
        "authorized_official_telephone_number": "503-292-7721",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OR",
            "license": "MDO6973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "061861",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Donald W Froom MDPC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 26, 2008; 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.