Carlos Ceballos, MD

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

Legal business name

CARLOS CEBALLOS, MD

Practice address

10373 NE Hancock St Ste 216
Portland, OR 97220-3873

Phone

(503) 650-4359

Fax

(503) 650-6913

NPI assigned

Apr 11, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Carlos Ceballos, MDNPI 1396774014

Title

Owner

Phone

(503) 650-4359

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Carlos Ceballos, MD

  • Pain Medicine Physician
  • Portland, OR
  • NPI 1396774014
  NPD (past) Authorized official
• Thomas Warren Bischoff, CRNA

  • Certified Registered Nurse Anesthetist
  • Crescent City, CA
  • NPI 1588680508
  NPD (past)

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639392269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 53",
            "city": "GLADSTONE",
            "state": "OR",
            "postal_code": "970270053",
            "telephone_number": "503-650-4359",
            "fax_number": "503-650-6913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10373 NE HANCOCK ST STE 216",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972203873",
            "telephone_number": "503-650-4359",
            "fax_number": "503-650-6913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLOS CEBALLOS, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CEBALLOS",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-650-4359",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kai Deva Carli, MA AT, ATR-P
• Jessica Carlin
• Deanne Hilde Carlisle, RD, MBA, LD
• James R Carlisle, MD
• Cody Carlman
• Kristi Carlough, LMT
• Adrienne Marie Carlson, DPT
• Barbara Carlson, M.S.
• Bernadette Elizabeth Carlson, LMT
• Bridget N Carlson, QMHA

• Pain Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Pain Medicine Physician in Oregon

• 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.