NPIMap

Organization Active NPI

Northwest Extremity Specialists LLC

  • Podiatric Clinic/Center
  • Wilsonville, OR
National Provider Identifier
1346973039
Registry record updated Jul 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
Legal business name
NORTHWEST EXTREMITY SPECIALISTS LLC
Practice address
29756 SW Town Center Loop W Ste H
Wilsonville, OR 97070-6482
Phone
(503) 245-2420
Fax
(503) 245-2445
NPI assigned
Jul 8, 2022
Organization subpart
Yes
Parent organization
NORTHWEST EXTREMITY SPECIALISTS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 8, 2022

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

Authorized official

Name
Thomas Charles Melillo, DPMNPI 1619085479
Title
Owner
Phone
(503) 245-2420

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
Podiatric Clinic/Center 261QP1100X Primary

Addresses

Primary practice location

29756 SW Town Center Loop W Ste H
Wilsonville, OR 97070-6482

Mailing address

9115 SW Oleson Rd Ste 205
Portland, OR 97223-6877
Phone (503) 245-2420

Other names 1

  • NES Wilsonville Doing business as

National Provider Directory

National Provider Directory
Part of
Northwest Extremity Specialists LLC

Locations

201 N Washington St
Newberg, OR 97132
Phone (503) 538-0800

5050 NE Hoyt St
Ste 411
Portland, OR 97213
Phone (503) 239-4324

16770 SW Edy Rd
#318
Sherwood, OR 97140

9115 SW Oleson Rd
Ste 205
Tigard, OR 97223
Phone (503) 243-5710

5493 Amy St
West Linn, OR 97068
Phone (503) 710-9839

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1657238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657238400000",
    "number": "1346973039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9115 SW OLESON RD STE 205",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972236877",
            "telephone_number": "503-245-2420",
            "fax_number": "503-245-2445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29756 SW TOWN CENTER LOOP W STE H",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970706482",
            "telephone_number": "503-245-2420",
            "fax_number": "503-245-2445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST EXTREMITY SPECIALISTS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHWEST EXTREMITY SPECIALISTS LLC",
        "enumeration_date": "2022-07-08",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A",
        "authorized_official_last_name": "MELILLO",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-245-2420",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NES Wilsonville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilsonville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2022; 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.