Organization Active NPI

G&H Healthcare Inc

  • Primary Care Nurse Practitioner
  • Portland, OR
National Provider Identifier
1376158774
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
G&H HEALTHCARE INC
Doing business as
G&H HEALTHCARE INC
Practice address
1340 SW Bertha Blvd Ste 103
Portland, OR 97219-2096
Phone
(888) 984-7277
Fax
(833) 989-2307
NPI assigned
Sep 11, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Authorized official

Name
Mrs. Kimberly L. Bradley, FNP-CNPI 1265939185
Title
Family Nurse Practitioner
Phone
(888) 984-7277

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X
Primary Care Clinic/Center 261QP2300X
Urgent Care Clinic/Center 261QU0200X
Primary Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP2300X Primary

Addresses

Primary practice location

1340 SW Bertha Blvd Ste 103
Portland, OR 97219-2096

Mailing address

1340 SW Bertha Blvd Ste 103
Portland, OR 97219-2096
Phone (888) 984-7277

Other names 1

  • G&H HEALTHCARE INC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20231120000977 OR Part B Supplier - Clinic/Group Practice 7719335470 Receives reassigned benefits from 1 practitioner
Practice locations: Portland, OR
O20250211001376 MS Part B Supplier - Clinic/Group Practice 7719335470 Receives reassigned benefits from 1 practitioner
Practice locations: Jackson, MS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D2289564G&H Healthcare Inc1340 SW Bertha Blvd, Ste 103, Portland, OR 97219Provider-performed microscopySep 11, 2027

National Provider Directory

National Provider Directory

Locations

1340 SW Bertha Blvd
Ste 103
Portland, OR 97219
Phone (209) 515-3571

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22281/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1599782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1376158774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 SW BERTHA BLVD STE 103",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972192096",
            "telephone_number": "888-984-7277",
            "fax_number": "503-386-2097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 SW BERTHA BLVD STE 103",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972192096",
            "telephone_number": "888-984-7277",
            "fax_number": "833-989-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G&H HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-11",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "888-984-7277",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "G&H HEALTHCARE INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.