Organization Active NPI

Advanced Medical Imaging of Portland, LLC

  • Diagnostic Radiology Physician
  • Milwaukie, OR
National Provider Identifier
1497086466
Registry record updated Jan 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
ADVANCED MEDICAL IMAGING OF PORTLAND, LLC
Practice address
6542 SE Lake Rd Ste 103
Milwaukie, OR 97222-2245
Phone
(503) 653-1699
Fax
(503) 653-3899
NPI assigned
Jan 14, 2010
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Levent Adam
Title
Director of Operations
Phone
(703) 970-2892

National Provider Directory

National Provider Directory

Locations

6542 SE Lake Rd
Ste 103
Milwaukie, OR 97222
Phone (503) 653-1699

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary

Addresses

NPPES NPI Registry

Primary practice location

6542 SE Lake Rd Ste 103
Milwaukie, OR 97222-2245

Mailing address

Department 4888
Carol Stream, IL 60122-4888
Phone (503) 657-8663

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
500618878MedicaidOR

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 6, 2011.

{
    "created_epoch": "1263427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294272000000",
    "number": "1497086466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPARTMENT 4888",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601224888",
            "telephone_number": "503-657-8663",
            "fax_number": "503-723-3180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6542 SE LAKE RD STE 103",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972222245",
            "telephone_number": "503-653-1699",
            "fax_number": "503-653-3899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED MEDICAL IMAGING OF PORTLAND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-14",
        "last_updated": "2011-01-06",
        "status": "A",
        "authorized_official_last_name": "ADAM",
        "authorized_official_first_name": "LEVENT",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "703-970-2892"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500618878",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukie, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2011; 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.