Careconnectmd Oregon Professional Corporation

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

CARECONNECTMD OREGON PROFESSIONAL CORPORATION

Practice address

555 SE Martin Luther King Jr Blvd Ste 105
Portland, OR 97214-2120

Phone

(888) 789-9585

NPI assigned

Jul 27, 2023

Last updated

Jul 27, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Hyong Kim, MD

Title

Owner

Phone

(888) 789-9585

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1690416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690416000000",
    "number": "1437830916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3090 BRISTOL ST STE 200",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 SE MARTIN LUTHER KING JR BLVD STE 105",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142120",
            "telephone_number": "888-789-9585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARECONNECTMD OREGON PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-27",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "HYONG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "888-789-9585",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Portland, OR
• Providers in Portland, OR by specialty
• General Practice Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; 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.