NPIMap

Organization Active NPI

Providence Portland Medical Center

  • Clinic/Center
  • Portland, OR
National Provider Identifier
1427258490
Registry record updated Dec 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
MD27617 Issued in OR
Legal business name
PROVIDENCE PORTLAND MEDICAL CENTER
Practice address
6241 SE Alder St
Portland, OR 97215-1971
Phone
(503) 334-7678
NPI assigned
Jul 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2014

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

Authorized official

Name
Dr. Adam Blomberg, MD
Title
Resident Physician
Phone
(503) 334-7678

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X MD27617 OR Primary

Addresses

Primary practice location

6241 SE Alder St
Portland, OR 97215-1971

Mailing address

6241 SE Alder St
Portland, OR 97215-1971

National Provider Directory

National Provider Directory
Tax ID family
Providence Portland Medical Center5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418169600000",
    "number": "1427258490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6241 SE ALDER ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6241 SE ALDER ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151971",
            "telephone_number": "503-334-7678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE PORTLAND MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-18",
        "last_updated": "2014-12-10",
        "status": "A",
        "authorized_official_last_name": "BLOMBERG",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "RESIDENT PHYSICIAN",
        "authorized_official_telephone_number": "503-334-7678",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OR",
            "license": "MD27617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 10, 2014; 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.