Cornell Urgent Care

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

MD22180 Issued in OR

Legal business name

CORNELL URGENT CARE

Practice address

1900 McLoughlin Blvd Ste 127
Oregon City, OR 97045-2078

Phone

(503) 305-6159

NPI assigned

Jan 11, 2012

Last updated

Jan 11, 2012By 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

Dr. Sejung Shin, M.D.

Title

President

Phone

(503) 646-8500

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Cornell Urgent Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Cornell Urgent Care

  • Urgent Care Clinic/Center
  • Beaverton, OR
  • NPI 1871864603
  NPD tax ID

Locations

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

{
    "created_epoch": "1326240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326240000000",
    "number": "1639449317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 MCLOUGHLIN BLVD STE 127",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970452078",
            "telephone_number": "503-305-6159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 MCLOUGHLIN BLVD STE 127",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970452078",
            "telephone_number": "503-305-6159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNELL URGENT CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-11",
        "last_updated": "2012-01-11",
        "status": "A",
        "authorized_official_last_name": "SHIN",
        "authorized_official_first_name": "SEJUNG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-646-8500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "OR",
            "license": "MD22180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024277",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaycee Amanda Copher
• Karen Marie Corban, LCSW
• Antonio Estevan Cordova, MD
• Lee Cordova, MD
• Laurel Lee Corkran, FNP
• Arminda Coronado, QMHP
• Samuel Stephen Cosgrove, NP
• Dawn Cottrell
• County of Clackamas Office of County Auditor
• County of Clackamas Office of County Auditor

• Urgent Care Clinic/Center in Oregon City, OR
• Providers in Oregon City, OR by specialty
• Urgent Care Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; 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.