Northwest Gastroenterology Clinic LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

NORTHWEST GASTROENTEROLOGY CLINIC LLC

Practice address

1130 NW 22ND Ave Ste 410
Portland, OR 97210-2911

Phone

(503) 229-7137

Fax

(503) 241-0628

NPI assigned

Nov 1, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Roland William Bennetts, MD

Title

Partner

Phone

(503) 229-7137

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 16

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

• Katherine Rollins Black, MD

  • Gastroenterology Physician
  • Portland, OR
  • NPI 1801018122
  Medicare reassignment Care Compare group NPD
• Jeffrey Charles Buehler, M.D.

  • Specialist
  • Portland, OR
  • NPI 1164534608
  Medicare reassignment Care Compare group NPD
• Benjamin Mark Hornung, M.D.

  • Hospitalist Physician
  • Portland, OR
  • NPI 1811317944
  Medicare reassignment Care Compare group NPD
• Meghan Allison Nesmith, M.D.

  • Gastroenterology Physician
  • Portland, OR
  • NPI 1356640544
  Medicare reassignment Care Compare group NPD
• Jeffrey Stephen Olson, M.D.

  • Gastroenterology Physician
  • Clackamas, OR
  • NPI 1730380791
  Medicare reassignment Care Compare group NPD
• Matthew Andres Smith, MD

  • Gastroenterology Physician
  • Portland, OR
  • NPI 1962590570
  Medicare reassignment Care Compare group NPD
• Katy C Stropnicky, FNP

  • Family Nurse Practitioner
  • Portland, OR
  • NPI 1902139462
  Medicare reassignment Care Compare group NPD
• Derek Carr Taylor, M.D.

  • Specialist
  • Portland, OR
  • NPI 1487766911
  Medicare reassignment Care Compare group NPD
• Maria Nina Villarreal, FNP

  • Family Nurse Practitioner
  • Portland, OR
  • NPI 1750538146
  Medicare reassignment Care Compare group NPD
• Erich David Vorlop, M.D.

  • Gastroenterology Physician
  • Portland, OR
  • NPI 1831315829
  Medicare reassignment Care Compare group NPD
• Kellie Young

  • Gastroenterology Physician
  • Portland, OR
  • NPI 1073908588

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Jay C Poorman, M.D.

  • Specialist
  • Portland, OR
  • NPI 1215049721
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434326400000",
    "number": "1407933872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 NW 22ND AVE STE 410",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102911",
            "telephone_number": "503-229-7137",
            "fax_number": "503-241-0628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 NW 22ND AVE STE 410",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102911",
            "telephone_number": "503-229-7137",
            "fax_number": "503-241-0628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST GASTROENTEROLOGY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2015-06-15",
        "status": "A",
        "authorized_official_last_name": "BENNETTS",
        "authorized_official_first_name": "ROLAND",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "503-229-7137",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northwest Family Acupuncture
• Northwest Family Mental Health Services LLC
• Northwest Family Services
• Northwest Foot & Ankle
• Northwest Forensic Institute
• Northwest Habilitation Services, LLC
• Northwest Heart Care LLC
• Northwest in Home Healthcare Agency
• Northwest Integrated Senior Services LLC
• Northwest IV, LLC

• Specialist in Portland, OR
• Providers in Portland, OR by specialty
• Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2015; 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.