Organization Active NPI

Dr N GYN

  • Obstetrics & Gynecology Physician
  • Lake Oswego, OR
National Provider Identifier
1558654178
Registry record updated Sep 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
13666 Issued in OR
Legal business name
DR N GYN
Practice address
17020 Pilkington Rd
Lake Oswego, OR 97035-5352
Phone
(503) 908-1646
Fax
(503) 908-1648
NPI assigned
May 16, 2011
Last updated
Sep 6, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2011

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

Authorized official

Name
Nancy J Salisbury, MDNPI 1669439113
Title
Owner/Physician
Phone
(503) 908-1646

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 13666 OR Primary

Addresses

Primary practice location

17020 Pilkington Rd
Lake Oswego, OR 97035-5352

Mailing address

17020 Pilkington Rd
Lake Oswego, OR 97035-5352
Phone (503) 908-1646

Other identifiers 1

IdentifierTypeStateIssuer
162370MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110921000801 OR Part B Supplier - Clinic/Group Practice 1759552862 Receives reassigned benefits from 4 practitioners
Practice locations: Lake Oswego, OR

National Provider Directory

National Provider Directory

Locations

17020 Pilkington Rd
Lake Oswego, OR 97035
Phone (503) 908-1646

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1305504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315267200000",
    "number": "1558654178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17020 PILKINGTON RD",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970355352",
            "telephone_number": "503-908-1646",
            "fax_number": "503-908-1648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17020 PILKINGTON RD",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970355352",
            "telephone_number": "503-908-1646",
            "fax_number": "503-908-1648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR N GYN",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-16",
        "last_updated": "2011-09-06",
        "status": "A",
        "authorized_official_last_name": "SALISBURY",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "503-908-1646",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OR",
            "license": "13666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162370",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.