Active NPI
Kerry Abbot Schaefer, MD
- Family Medicine Physician
- Portland, OR
National Provider Identifier
1497902373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD151149
- Practice address
- 3605 SE 26TH Ave
Portland, OR 97202-2953 - Phone
- (503) 320-6825
- Fax
- (503) 548-4013
- NPI assigned
- Aug 22, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD151149 | OR | Primary |
Addresses
Primary practice location
3605 SE 26TH Ave
Portland, OR 97202-2953
Mailing address
3605 SE 26TH Ave
Portland, OR 97202-2953
Phone (971) 231-4536
Other practice location 1
314 NE 19th Ave
Portland, OR 97232-2829
Phone (503) 239-8181
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500655237 | Medicaid | OR |
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 |
|---|---|---|---|
| Portland Family Practice Inc. | Family Medicine | Past | Accepting new patients |
| Portland Clinic | Family Medicine | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Portland, OR
- NPI 1508857657
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1497902373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3605 SE 26TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972022953",
"telephone_number": "971-231-4536",
"fax_number": "503-376-3790"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3605 SE 26TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972022953",
"telephone_number": "503-320-6825",
"fax_number": "503-548-4013"
}
],
"practiceLocations": [
{
"address_1": "314 NE 19th Ave",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972322829",
"country_code": "US",
"telephone_number": "503-239-8181",
"fax_number": "503-548-4013",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SCHAEFER",
"first_name": "KERRY",
"middle_name": "ABBOT",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-08-22",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD151149",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500655237",
"state": "OR"
}
],
"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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.