Kathleen Rose Farrell, D.O.

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

DO16024 Issued in OR

Practice address

4531 SE Belmont St
Suite 100
Portland, OR 97215-1675

Phone

(503) 215-9823

NPI assigned

Feb 8, 2006

Sex

Female

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 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1720051998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4531 SE BELMONT ST STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4531 SE BELMONT ST",
            "address_2": "SUITE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151675",
            "telephone_number": "503-215-9823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRELL",
        "first_name": "KATHLEEN",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-08",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "OR",
            "license": "DO16024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018551",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kfarrell199716@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "18650 NW Cornell Rd Ste 215",
            "city": "Hillsboro",
            "state": "OR",
            "country_code": "US",
            "postal_code": "971249212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kfarrell199716@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "4531 SE Belmont St",
            "address_2": "Suite 100",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972151675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carrie Farrell, LPC, LMT
• Elizabeth Farrell
• Elizabeth Marie Farrell, PMHNP-BC
• Joanna Rae Farrell, CRNP
• Julia Rachel Farrell, OTR
• Lori J. Farrell, M.D.
• Marina Farrell
• Sarah Elizabeth Farrell, MD
• Marieka Caitlin Farrenkopf, EDM, LCSW
• Jodi Arnoff Farrera, CNM

• All providers in Portland, OR
• Geriatric Medicine (Internal Medicine) Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.