NPIMap

Organization Active NPI

Oregon Health & Science University

Doing business as OHSU Family Medicine at Richmond Walk-In Clinic

  • Federally Qualified Health Center (FQHC)
  • Portland, OR
National Provider Identifier
1487902706
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
OREGON HEALTH & SCIENCE UNIVERSITY
Doing business as
OHSU Family Medicine at Richmond Walk-In Clinic
Richmond Immediate Care
Practice address
4212 SE Division St Ste 150
Portland, OR 97206-1681
Phone
(503) 418-1500
Fax
(503) 418-3939
NPI assigned
Aug 16, 2012
Last updated
Sep 12, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
OREGON HEALTH & SCIENCE UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Authorized official

Name
Kelly Anne Smith
Title
VP/Enterprise Revenue Cycle
Phone
(503) 494-4422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

4212 SE Division St Ste 150
Portland, OR 97206-1681

Mailing address

1400 SW 5TH Ave Ste 500
Portland, OR 97201-5537
Phone (503) 418-1500

Other identifiers 1

IdentifierTypeStateIssuer
500682277MedicaidOR

Other names 2

  • OHSU Family Medicine at Richmond Walk-In Clinic Doing business as
  • Richmond Immediate Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050516000173 OR Part B Supplier - Clinic/Group Practice 1759328842 Receives reassigned benefits from 168 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Portland, OR; Scappoose, OR
O20130805000662 OR Part A Provider - Federally Qualified Health Center (FQHC) 1759328842 Practice locations: Portland, OR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487902706. Details of each certification follow.

Federally qualified health center certification: CCN 381938

Legal name
OREGON HEALTH & SCIENCE UNIVERSITY
Doing business as
RICHMOND IMMEDIATE CARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 16, 2013
Last certification
Jul 16, 2013
Ownership / control type
For profit – corporation
Organization structure
GovernmentNon-profit
Incorporated
Jul 9, 1995 in OR
Enrollment address
4212 SE Division St
Ste 150
Portland, OR 97206-1681

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Ohsu Hospitals Clinic

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Sandra L Catalan Individual Corporate OfficerSVP, Chief Accounting Officer Oct 30, 2017
Corporate DirectorSVP, Chief Accounting Officer Oct 30, 2017
W-2 Managing EmployeeSVP, Chief Accounting Officer Oct 30, 2017
Shereef M Elnahal Individual Corporate OfficerPresident, Ohsu Aug 11, 2025
Corporate DirectorPresident, Ohsu Aug 11, 2025
W-2 Managing EmployeePresident, Ohsu Aug 11, 2025
Oregon Health & Science University Organization, Portland, OR 5% Or Greater Direct Ownership Interest Jun 10, 2013 100%
Operational/Managerial Control Jun 10, 2013 100%
Kelly Smith Individual Corporate OfficerVP, Enterprise Revenue Cycle Apr 5, 2021
Corporate DirectorVP, Enterprise Revenue Cycle Apr 5, 2021
W-2 Managing EmployeeVP, Enterprise Revenue Cycle Apr 5, 2021

Owners & managing parties with NPI records 10

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 6

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 48

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1345075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757635200000",
    "number": "1487902706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 SW 5TH AVE STE 500",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972015537",
            "telephone_number": "503-418-1500",
            "fax_number": "503-418-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4212 SE DIVISION ST STE 150",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972061681",
            "telephone_number": "503-418-1500",
            "fax_number": "503-418-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON HEALTH & SCIENCE UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OREGON HEALTH & SCIENCE UNIVERSITY",
        "enumeration_date": "2012-08-16",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "VP/ENTERPRISE REVENUE CYCLE",
        "authorized_official_telephone_number": "503-494-4422"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500682277",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OHSU Family Medicine at Richmond Walk-In Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Richmond Immediate Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.