Active NPI
RTHM Medical Group, P.a.
- Internal Medicine Physician
- Portland, OR
National Provider Identifier
1417709205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- RTHM MEDICAL GROUP, P.A.
- Practice address
- 6036 SE 40TH Ave
Portland, OR 97202-7616 - Phone
- (770) 687-7654
- NPI assigned
- Apr 4, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Stuart Malcolm
- Title
- Owner
- Phone
- (770) 687-7654
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
6036 SE 40TH Ave
Portland, OR 97202-7616
Mailing address
6036 SE 40TH Ave
Portland, OR 97202-7616
Other practice location 1
698 12th St SE Ste 200
Salem, OR 97301-4010
Phone (408) 508-4163
Other practice location 2
1601 Elm St Ste 4360
Dallas, TX 75201-4701
Phone (408) 508-4163
Other practice location 3
115 N Calhoun St Ste 4
Tallahassee, FL 32301-1568
Phone (408) 508-4163
Other practice location 4
448 Saint Francis St
Redwood City, CA 94062
Phone (408) 508-4163
Other practice location 5
300 W Clarendon Ave Ste 240
Phoenix, AZ 85013-3479
Phone (408) 508-4163
Other names 1
- RTHM Medical Group
National Provider Directory
National Provider DirectoryLocations
698 12th St SE
Ste 200
Salem, OR 97301
Phone (339) 499-9815
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712188800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1731974400000",
"number": "1417709205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6036 SE 40TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972027616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6036 SE 40TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972027616",
"telephone_number": "770-687-7654"
}
],
"practiceLocations": [
{
"address_1": "698 12th St SE Ste 200",
"address_purpose": "LOCATION",
"city": "Salem",
"state": "OR",
"postal_code": "973014010",
"country_code": "US",
"telephone_number": "408-508-4163",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1601 Elm St Ste 4360",
"address_purpose": "LOCATION",
"city": "Dallas",
"state": "TX",
"postal_code": "752014701",
"country_code": "US",
"telephone_number": "408-508-4163",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "115 N Calhoun St Ste 4",
"address_purpose": "LOCATION",
"city": "Tallahassee",
"state": "FL",
"postal_code": "323011568",
"country_code": "US",
"telephone_number": "408-508-4163",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "448 Saint Francis St",
"address_purpose": "LOCATION",
"city": "Redwood City",
"state": "CA",
"postal_code": "94062",
"country_code": "US",
"telephone_number": "408-508-4163",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "300 W Clarendon Ave Ste 240",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850133479",
"country_code": "US",
"telephone_number": "408-508-4163",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "RTHM MEDICAL GROUP, P.A.",
"organizational_subpart": "NO",
"enumeration_date": "2024-04-04",
"last_updated": "2024-11-19",
"certification_date": "2024-10-21",
"status": "A",
"authorized_official_last_name": "MALCOLM",
"authorized_official_first_name": "STUART",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "770-687-7654"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "RTHM Medical Group",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "RTHM Medical Group",
"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 Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.