NPIMap

Organization Active NPI

Northwest Renal Clinic, Inc.

  • Nephrology Physician
  • McMinnville, OR
National Provider Identifier
1346081213
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
NORTHWEST RENAL CLINIC, INC.
Practice address
232 NE Norton LN
McMinnville, OR 97128-8470
Phone
(503) 434-1159
Fax
(503) 434-1190
NPI assigned
Jun 4, 2024
Last updated
Jun 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Authorized official

Name
Clayton M Smiley, MDNPI 1679544431
Title
MD
Phone
(503) 229-7976

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

232 NE Norton LN
McMinnville, OR 97128-8470

Mailing address

232 NE Norton LN
McMinnville, OR 97128-8470
Phone (503) 434-1159

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040429000295 OR Part B Supplier - Clinic/Group Practice 8628065836 Receives reassigned benefits from 38 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Portland, OR; Tualatin, OR; Salem, OR; McMinnville, OR; Hillsboro, OR; Clackamas, OR

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Northwest Renal CL Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

633 Ponahawai St
Ste 103
Hilo, HI 96720
Phone (808) 481-2300

12550 SE 93rd Ave
Ste 250
Clackamas, OR 97015
Phone (503) 654-1153

9155 SW Barnes Rd
Ste 330
Portland, OR 97225
Phone (503) 292-7704

19250 SW 65th Ave
Ste 245
Tualatin, OR 97062
Phone (503) 692-7971

8050 SW Warm Springs St
Ste 150
Tualatin, OR 97062
Phone (503) 692-7971

Practitioners & affiliated clinicians

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1346081213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 NE NORTON LN",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971288470",
            "telephone_number": "503-434-1159",
            "fax_number": "503-434-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 NE NORTON LN",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971288470",
            "telephone_number": "503-434-1159",
            "fax_number": "503-434-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST RENAL CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "SMILEY",
        "authorized_official_first_name": "CLAYTON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "503-229-7976",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McMinnville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.