NPIMap

Organization Active NPI

Thomas D Utterback, MD, PC

  • Specialist
  • Canby, OR
National Provider Identifier
1710208962
Registry record updated Jun 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD07612 Issued in OR
Legal business name
THOMAS D UTTERBACK, MD, PC
Practice address
8051 S Lone Elder Rd
Canby, OR 97013-9127
Phone
(503) 263-2400
NPI assigned
Jun 22, 2010
Last updated
Jun 22, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2010

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

Authorized official

Name
Dr. Thomas D Utterback, M.D.NPI 1598736308
Title
Doctor
Phone
(503) 236-2400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD07612 OR Primary

Addresses

Primary practice location

8051 S Lone Elder Rd
Canby, OR 97013-9127

Mailing address

PO Box 942
Canby, OR 97013-0942
Phone (503) 263-2400

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1277164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277164800000",
    "number": "1710208962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 942",
            "city": "CANBY",
            "state": "OR",
            "postal_code": "970130942",
            "telephone_number": "503-263-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8051 S LONE ELDER RD",
            "city": "CANBY",
            "state": "OR",
            "postal_code": "970139127",
            "telephone_number": "503-263-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS D UTTERBACK, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-22",
        "last_updated": "2010-06-22",
        "status": "A",
        "authorized_official_last_name": "UTTERBACK",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "503-236-2400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "MD07612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canby, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2010; 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.