Individual provider Active NPI

Robert C Livingston, MD

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1457480907
Registry record updated Mar 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD160568 Issued in OR
Practice address
75 NW Couch St
Portland, OR 97209-4018
Phone
(505) 577-3037
NPI assigned
Mar 2, 2007
Last updated
Mar 14, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2001-242 NM
Internal Medicine Physician 207R00000X MD160568 OR Primary

Addresses

Primary practice location

75 NW Couch St
Portland, OR 97209-4018

Mailing address

75 NW Couch St
Portland, OR 97209-4018
Phone (505) 577-3037

Other identifiers 1

IdentifierTypeStateIssuer
68583851MedicaidNM

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

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Clara Health Center PastSince Jan 19, 2012 Accepting new patients
Cochiti Health Clinic Past Accepting new patients
Santo Domingo Health Clinic Past Accepting new patients
Primecare Physician Associates Internal Medicine Past Accepting new patients
San Felipe Health Clinic Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457913600000",
    "number": "1457480907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 NW COUCH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972094018",
            "telephone_number": "505-577-3037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 NW COUCH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972094018",
            "telephone_number": "505-577-3037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVINGSTON",
        "first_name": "ROBERT",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2016-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "2001-242",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD160568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "68583851",
            "state": "NM"
        }
    ],
    "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 Mar 14, 2016; 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.