NPIMap

Organization Active NPI

Pacific Surgical PC

  • Specialist
  • Portland, OR
National Provider Identifier
1396792990
Registry record updated Nov 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PACIFIC SURGICAL PC
Practice address
501 N Graham St
Suite 580
Portland, OR 97227-1654
Phone
(503) 528-0704
Fax
(503) 528-0708
NPI assigned
May 28, 2006
Last updated
Nov 16, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2007

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

Authorized official

Name
Mr. Kerry Lowery
Title
Ceo
Phone
(503) 528-0704

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

501 N Graham St
Suite 580
Portland, OR 97227-1654

Mailing address

PO Box 23200
Portland, OR 97281-3200
Phone (503) 528-0704

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 28

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 28

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195171200000",
    "number": "1396792990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972813200",
            "telephone_number": "503-528-0704",
            "fax_number": "503-528-0708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N GRAHAM ST",
            "address_2": "SUITE 580",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271654",
            "telephone_number": "503-528-0704",
            "fax_number": "503-528-0708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC SURGICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2007-11-16",
        "status": "A",
        "authorized_official_last_name": "LOWERY",
        "authorized_official_first_name": "KERRY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "503-528-0704",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Nov 16, 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.

Verify at the official NPI Registry.