Active NPI
Futures Outpatient Surgical Center
- Ambulatory Surgical Clinic/Center
- Portland, OR
National Provider Identifier
1518022615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- License
- 071440
- Legal business name
- FUTURES OUTPATIENT SURGICAL CENTER
- Practice address
- 1849 NW Kearney St Ste 302
Portland, OR 97209-1453 - Phone
- (503) 525-3653
- Fax
- (503) 224-9081
- NPI assigned
- Dec 27, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Bryce E Potter, MD, DMD, FACS
- Title
- Owner
- Phone
- (503) 224-1371
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | 071440 | OR | Primary |
Addresses
Primary practice location
1849 NW Kearney St Ste 302
Portland, OR 97209-1453
Mailing address
1849 NW Kearney St Ste 302
Portland, OR 97209-1453
Phone (503) 525-3653
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000644 | Medicaid | OR |
National Provider Directory
National Provider DirectoryLocations
1849 NW Kearney St
#302
Portland, OR 97209
Phone (503) 224-0723
1849 NW Kearney St
Ste 302
Portland, OR 97209
Phone (503) 525-3653
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167177600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1518022615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1849 NW KEARNEY ST STE 302",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972091453",
"telephone_number": "503-525-3653",
"fax_number": "503-224-9081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1849 NW KEARNEY ST STE 302",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972091453",
"telephone_number": "503-525-3653",
"fax_number": "503-224-9081"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FUTURES OUTPATIENT SURGICAL CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-27",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "POTTER",
"authorized_official_first_name": "BRYCE",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "503-224-1371",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD, DMD, FACS"
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": "OR",
"license": "071440",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000644",
"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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.