Individual provider Active NPI

Robert Glenn Pittenger, M.D.

  • Internal Medicine Physician
  • McMinnville, OR
National Provider Identifier
1619118627
Registry record updated Mar 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD04595 Issued in OR
Practice address
14996 NW Orchard View Rd
McMinnville, OR 97128-8083
Phone
(503) 474-0841
NPI assigned
Mar 20, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD04595 OR Primary

Addresses

Primary practice location

14996 NW Orchard View Rd
McMinnville, OR 97128-8083

Mailing address

14996 NW Orchard View Rd
McMinnville, OR 97128-8083
Phone (503) 474-0841

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4595ORMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1237507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237507200000",
    "number": "1619118627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14996 NW ORCHARD VIEW RD",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971288083",
            "telephone_number": "503-474-0841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14996 NW ORCHARD VIEW RD",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971288083",
            "telephone_number": "503-474-0841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITTENGER",
        "first_name": "ROBERT",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-20",
        "last_updated": "2009-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD04595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McMinnville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2009; 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.