Clinton E Preston, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD172857 Issued in OR

Practice address

1700 Geary St SE
Albany, OR 97322-6842

Phone

(541) 812-5500

Fax

(541) 812-5505

NPI assigned

Oct 17, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439164800000",
    "number": "1467441048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 GEARY ST SE",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973226842",
            "telephone_number": "541-812-5500",
            "fax_number": "541-812-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 GEARY ST SE",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973226842",
            "telephone_number": "541-812-5500",
            "fax_number": "541-812-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTON",
        "first_name": "CLINTON",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2015-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WY",
            "license": "6238A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD172857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "311187",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114905900",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0057811",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080179382",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diane Janel Popp, LCSW
• Cori Porter, LMT
• Patricia Diane Post, CRM
• Megan Kristina Postelwait
• Rachel Powell, RN
• Julia Preuss, PA-C
• Alaine Tay Shomali Prevish, DMD
• Philip A. Prewette, M.A.
• Travis Holden Prichard
• Kayla Cherie Priddy

• Emergency Medicine Physician in Albany, OR
• Providers in Albany, OR by specialty
• Emergency Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.

Verify at the official NPI Registry.