Active NPI
Vincent Harrison
- Surgery Physician
- Portland, OR
National Provider Identifier
1659573111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- MD29110
- Practice address
- 4805 NE Glisan St
Portland, OR 97213 - Phone
- (503) 000-0000
- Fax
- (503) 000-0000
- NPI assigned
- Jun 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 4301082279 | MI | |
| Surgery Physician | 208600000X | MD29110 | OR | Primary |
Addresses
Primary practice location
4805 NE Glisan St
Portland, OR 97213
Mailing address
PO Box 1334
Portland, OR 97207-1334
Phone (313) 347-3290
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4301082279 | MI | MD | Surgery Physician |
| MD29110 | OR | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401840000000",
"number": "1659573111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1334",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972071334",
"telephone_number": "313-347-3290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4805 NE GLISAN ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97213",
"telephone_number": "503-000-0000",
"fax_number": "503-000-0000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRISON",
"first_name": "VINCENT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-05",
"last_updated": "2014-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MI",
"license": "4301082279",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "OR",
"license": "MD29110",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.