Advanced Internal Medicine Group, PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

ADVANCED INTERNAL MEDICINE GROUP, PC

Practice address

9555 SW Barnes Rd Ste 255
Portland, OR 97225-6654

Phone

(503) 908-1590

Fax

(503) 723-2862

NPI assigned

Feb 24, 2016

Organization subpart

No

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

Authorized official

Name

Sarah Edson

Title

Practice Administrator

Phone

(503) 908-1590

Specialties & licenses 1

Addresses

Other names 1

• AIM Health Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amy K Gillcrist, MD

  • Internal Medicine Physician
  • West Linn, OR
  • NPI 1952347528
  Medicare reassignment Care Compare group NPD
• Merrill G Harris, MD

  • Hospitalist Physician
  • Portland, OR
  • NPI 1114956422
  Medicare reassignment Care Compare group NPD
• Annie Seapan Mack, MD

  • Pediatrics Physician
  • Portland, OR
  • NPI 1932125184
  Medicare reassignment Care Compare group NPD
• Dorelan L Miller, MD

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1366768004
  Medicare reassignment Care Compare group NPD
• Kimberly A Shields, DO

  • Family Medicine Physician
  • Portland, OR
  • NPI 1104841543
  Medicare reassignment Care Compare group NPD
• Phonekeo Khamvanthong, MD

  • Family Medicine Physician
  • Enid, OK
  • NPI 1750519922

  OR

  Medicare reassignment Care Compare group NPD
• Ying Long, M.D.

  • Internal Medicine Physician
  • Marshall, MN
  • NPI 1437600947

  OR

  Medicare reassignment Care Compare group NPD
• Cynthia J Ferrier, M.D.

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1285607440
  Medicare reassignment NPD
• Thomas G Gragnola, MD

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1144220765
  Medicare reassignment NPD
• Summer R Lam, MD

  • Internal Medicine Physician
  • Newberg, OR
  • NPI 1922266709
  Medicare reassignment NPD
• Jill Elaine Miller, MD

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1053327544
  Medicare reassignment NPD

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

{
    "created_epoch": "1456272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669766400000",
    "number": "1487014163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9555 SW BARNES RD STE 255",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256654",
            "telephone_number": "503-908-1590",
            "fax_number": "503-723-2862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9555 SW BARNES RD STE 255",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256654",
            "telephone_number": "503-908-1590",
            "fax_number": "503-723-2862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED INTERNAL MEDICINE GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-24",
        "last_updated": "2022-11-30",
        "certification_date": "2022-01-12",
        "status": "A",
        "authorized_official_last_name": "EDSON",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "503-908-1590"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AIM Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Advance Injury Care and Movement Therapy LLC
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• Advanced Dental Arts NW
• Advanced Health Care Center
• Advanced Massage Concepts, LLC
• Advanced Pain Management Center
• Advanced Pain Management Center PC
• Advanced Pediatric Therapies
• Advanced Primary Care of Oregon LLC

• Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.