NPIMap

Organization Active NPI

Advantage Medical Group LLP

  • Internal Medicine Physician
  • Tigard, OR
National Provider Identifier
1578633616
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ADVANTAGE MEDICAL GROUP LLP
Practice address
9900 SW Hall Blvd
#200
Tigard, OR 97223
Phone
(503) 293-1515
Fax
(503) 595-3905
NPI assigned
Nov 8, 2006
Last updated
Aug 22, 2020By the provider in NPPES
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. Daniel Keith Mangum, DONPI 1710055322
Title
DO Owner
Phone
(503) 293-1515

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

9900 SW Hall Blvd
#200
Tigard, OR 97223

Mailing address

9900 SW Hall Blvd
#200
Tigard, OR 97223
Phone (503) 293-1515

National Provider Directory

National Provider Directory

Locations

9735 SW Shady Ln
Tigard, OR 97223
Phone (503) 807-7413

9900 SW Hall Blvd
Ste 200
Tigard, OR 97223
Phone (503) 293-1515

9900 SW Hall Blvd
Ste 200972235843
Tigard, OR 97223
Phone (503) 968-1515

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": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1578633616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 SW HALL BLVD",
            "address_2": "#200",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "97223",
            "telephone_number": "503-293-1515",
            "fax_number": "503-595-3905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 SW HALL BLVD",
            "address_2": "#200",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "97223",
            "telephone_number": "503-293-1515",
            "fax_number": "503-595-3905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANTAGE MEDICAL GROUP LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MANGUM",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "DO OWNER",
        "authorized_official_telephone_number": "503-293-1515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, 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.