Active NPI
David E Gannett Jr., MD
- Radiation Oncology Physician
- Portland, OR
National Provider Identifier
1467454165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- License
- MD20984
- Practice address
- 9205 SW Barnes Rd
Portland, OR 97225-6603 - Phone
- (503) 216-2195
- Fax
- (503) 216-2196
- NPI assigned
- Aug 11, 2005
- 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 |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | MD20984 | OR | Primary |
Addresses
Primary practice location
9205 SW Barnes Rd
Portland, OR 97225-6603
Mailing address
847 NE 19TH Ave
Suite 300
Portland, OR 97232-2684
Phone (503) 963-2801
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 150948 | Medicaid | OR | |
| 8220857 | Medicaid | WA |
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Oncology PC | Radiation Oncology | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379289600000",
"number": "1467454165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "847 NE 19TH AVE",
"address_2": "SUITE 300",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972322684",
"telephone_number": "503-963-2801",
"fax_number": "503-963-2825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9205 SW BARNES RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972256603",
"telephone_number": "503-216-2195",
"fax_number": "503-216-2196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANNETT",
"first_name": "DAVID",
"middle_name": "E",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-11",
"last_updated": "2013-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "OR",
"license": "MD20984",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "150948",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8220857",
"state": "WA"
}
],
"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 Sep 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.