Fertile Ground Family Center, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

2921 Issued in OR

Legal business name

FERTILE GROUND FAMILY CENTER, LLC

Practice address

3575 NE Broadway St
Portland, OR 97232-1820

Phone

(503) 284-6195

NPI assigned

Dec 13, 2012

Last updated

Dec 13, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Caroline Peterson, DC, PHD, MPH, LDM

Title

Director

Phone

(503) 284-6195

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1355356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355356800000",
    "number": "1558607812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3575 NE BROADWAY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321820",
            "telephone_number": "503-284-6195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3575 NE BROADWAY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321820",
            "telephone_number": "503-284-6195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERTILE GROUND FAMILY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-13",
        "last_updated": "2012-12-13",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "CAROLINE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "503-284-6195",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC, PHD, MPH, LDM"
    },
    "taxonomies": [
        {
            "code": "261QB0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Birthing",
            "state": "OR",
            "license": "DEM-LD-10144749",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OR",
            "license": "2921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Michael Ferry, MD
• Marissa Ferry
• Megan Ferry, LMT
• Amber Ferschweiler, NBHWC
• Evan Jacob Fertig, MD
• Aklilu Feseha
• Ayahun Feseha
• Jill L Fessenden, BSN, LMT, ABLS
• Jonathan Mark Fessler, BA, FNTP, LMT, CA
• Samuel John Fessler

• Primary Care Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Primary Care Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2012; 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.