Organization Active NPI

RTHM Medical Group, P.a.

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1417709205
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
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

Updated by the provider on Nov 19, 2024

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)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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 Doing business as

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.