NPIMap

Organization Active NPI

Oregon Orthotic Services

Doing business as Evergreen Prosthetics and Orthotics

  • Prosthetic/Orthotic Supplier
  • Beaverton, OR
National Provider Identifier
1619445657
Registry record updated Jun 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
OREGON ORTHOTIC SERVICES
Doing business as
Evergreen Prosthetics and Orthotics
Practice address
8880 SW Nimbus Ave Ste a
Beaverton, OR 97008-7111
Phone
(877) 971-7272
NPI assigned
Nov 7, 2018
Last updated
Jun 5, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2019

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

Authorized official

Name
Timothy L O'NeillNPI 1700400249
Title
Owner
Phone
(503) 704-5408

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
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

8880 SW Nimbus Ave Ste a
Beaverton, OR 97008-7111

Mailing address

8880 SW Nimbus Ave Ste a
Beaverton, OR 97008-7111
Phone (877) 971-7272

Other identifiers 1

IdentifierTypeStateIssuer
27475MedicaidOR

Other names 1

  • Evergreen Prosthetics and Orthotics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Evergreen Prosthetics and Orthotics LLC15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Practitioners & affiliated clinicians

Practitioners 1

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": "1541548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559692800000",
    "number": "1619445657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8880 SW NIMBUS AVE STE A",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970087111",
            "telephone_number": "877-971-7272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8880 SW NIMBUS AVE STE A",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970087111",
            "telephone_number": "877-971-7272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON ORTHOTIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-07",
        "last_updated": "2019-06-05",
        "status": "A",
        "authorized_official_last_name": "O'NEILL",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-704-5408"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "27475",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Prosthetics and Orthotics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; 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.