NPIMap

Organization Active NPI

Westside Podiatry Clinic LLC

  • Podiatrist
  • Tigard, OR
National Provider Identifier
1427164516
Registry record updated Jul 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
WESTSIDE PODIATRY CLINIC LLC
Practice address
9900 SW Hall Blvd
Suit 100
Tigard, OR 97223
Phone
(503) 245-2420
Fax
(503) 245-2445
NPI assigned
Aug 22, 2006
Last updated
Jul 21, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2010

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

Authorized official

Name
Dr. Jason R Surratt, DPMNPI 1649386541
Title
Owner
Phone
(503) 245-2420

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X NU Primary

Addresses

Primary practice location

9900 SW Hall Blvd
Suit 100
Tigard, OR 97223

Mailing address

9900 SW Hall Blvd
Suit 100
Tigard, OR 97223
Phone (503) 245-2420

National Provider Directory

National Provider Directory

Locations

9900 SW Hall Blvd
Ste 100
Tigard, OR 97223

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279670400000",
    "number": "1427164516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 SW HALL BLVD",
            "address_2": "SUIT 100",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "97223",
            "telephone_number": "503-245-2420",
            "fax_number": "503-245-2445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 SW HALL BLVD",
            "address_2": "SUIT 100",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "97223",
            "telephone_number": "503-245-2420",
            "fax_number": "503-245-2445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSIDE PODIATRY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2010-07-21",
        "status": "A",
        "authorized_official_last_name": "SURRATT",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-245-2420",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2010; 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.