NPIMap

Organization Active NPI

Northwest Extremity Specialists LLC

  • Medical Specialty Clinic/Center
  • Tigard, OR
National Provider Identifier
1629774179
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
NORTHWEST EXTREMITY SPECIALISTS LLC
Practice address
9445 SW Locust St
Tigard, OR 97223-6634
Phone
(503) 245-2420
NPI assigned
Feb 6, 2023
Last updated
Aug 30, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTHWEST EXTREMITY SPECIALISTS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Authorized official

Name
Sheadawn Fogerson
Title
Area Operations Director
Phone
(503) 352-1313

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU
Medical Specialty Clinic/Center 261QM2500X NU Primary

Addresses

Primary practice location

9445 SW Locust St
Tigard, OR 97223-6634

Mailing address

9115 SW Oleson Rd Ste 205
Portland, OR 97223-6877
Phone (503) 245-2420

Other practice location 1

6485 SW Borland Rd Ste A
Tualatin, OR 97062-9762
Phone (503) 352-1313

Other identifiers 1

IdentifierTypeStateIssuer
1174973242OtherCAORTHOPEDIC

Other names 1

  • NES Orthopedics Other name

National Provider Directory

National Provider Directory
Tax ID family
Northwest Extremity Specialists LLC4 organizations share this tax ID, including this one
Part of
Northwest Extremity Specialists LLC

Other organizations with this tax ID 3

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

Locations

9445 SW Locust St
Tigard, OR 97223
Phone (503) 352-1313

NPI Registry JSON

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

{
    "created_epoch": "1675641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693353600000",
    "number": "1629774179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9115 SW OLESON RD STE 205",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972236877",
            "telephone_number": "503-245-2420",
            "fax_number": "503-245-2445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9445 SW LOCUST ST",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236634",
            "telephone_number": "503-245-2420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6485 SW Borland Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Tualatin",
            "state": "OR",
            "postal_code": "970629762",
            "country_code": "US",
            "telephone_number": "503-352-1313",
            "fax_number": "503-352-1314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTHWEST EXTREMITY SPECIALISTS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHWEST EXTREMITY SPECIALISTS LLC",
        "enumeration_date": "2023-02-06",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A",
        "authorized_official_last_name": "FOGERSON",
        "authorized_official_first_name": "SHEADAWN",
        "authorized_official_title_or_position": "AREA OPERATIONS DIRECTOR",
        "authorized_official_telephone_number": "503-352-1313"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORTHOPEDIC",
            "identifier": "1174973242",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NES Orthopedics",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "NES Orthopedics",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 30, 2023; 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.