Lee Cordova, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD09119 Issued in OR

Practice address

1001 Molalla Ave
Ste 100
Oregon City, OR 97045-3788

Phone

(503) 656-5273

Fax

(503) 650-4828

NPI assigned

May 16, 2006

Reactivated

Feb 14, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.61288

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pacific Medical Group, PC

  • Clinic/Center
  • Lake Oswego, OR
  • NPI 1477636561
  NPD (past)

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329177600000",
    "number": "1699727917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 CENTERPOINTE DR",
            "address_2": "STE 200",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970358653",
            "telephone_number": "503-797-2268",
            "fax_number": "503-234-8227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 MOLALLA AVE",
            "address_2": "STE 100",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970453788",
            "telephone_number": "503-656-5273",
            "fax_number": "503-650-4828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDOVA",
        "first_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2012-02-14",
        "deactivation_date": "2011-12-28",
        "reactivation_date": "2012-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD09119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "238659",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR PIN NUMBER",
            "identifier": "110154334",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arthur D Cooper, M.D.
• Ethel Cooper
• Jaycee Amanda Copher
• Karen Marie Corban, LCSW
• Antonio Estevan Cordova, MD
• Laurel Lee Corkran, FNP
• Cornell Urgent Care
• Arminda Coronado, QMHP
• Samuel Stephen Cosgrove, NP
• Dawn Cottrell

• Internal Medicine Physician in Oregon City, OR
• Providers in Oregon City, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.