Organization Active NPI

Futures Outpatient Surgical Center

  • Ambulatory Surgical Clinic/Center
  • Portland, OR
National Provider Identifier
1518022615
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
071440 Issued in OR
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

Updated by the provider on Aug 22, 2020

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
000644MedicaidOR

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.