Active NPI
Paul M Meyer-Strom, M.D.
- Child & Adolescent Psychiatry Physician
- Beaverton, OR
National Provider Identifier
1427183839
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 15742
- Practice address
- 4855 SW Western Ave
Beaverton, OR 97005-3460 - Phone
- (503) 249-3434
- NPI assigned
- Feb 23, 2007
- Last updated
- Aug 19, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 15742 | OR | Primary |
Addresses
Primary practice location
4855 SW Western Ave
Beaverton, OR 97005-3460
Mailing address
4855 SW Western Ave
Beaverton, OR 97005-3460
Phone (503) 249-3434
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001169 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15742 | OR | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439942400000",
"number": "1427183839",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4855 SW WESTERN AVE",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970053460",
"telephone_number": "503-249-3434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4855 SW WESTERN AVE",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970053460",
"telephone_number": "503-249-3434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEYER-STROM",
"first_name": "PAUL",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-23",
"last_updated": "2015-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "OR",
"license": "15742",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001169",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.