Individual provider Active NPI

Carole Levanda, MD

  • Obstetrics & Gynecology Physician
  • Portland, OR
National Provider Identifier
1730199720
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD14048 Issued in OR
Practice address
1130 NW 22ND Ave
Ste 520
Portland, OR 97210-2976
Phone
(503) 274-4800
Fax
(503) 274-4917
NPI assigned
Aug 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD14048 OR Primary

Addresses

Primary practice location

1130 NW 22ND Ave
Ste 520
Portland, OR 97210-2976

Mailing address

1130 NW 22ND Ave
Ste 520
Portland, OR 97210-2976
Phone (503) 274-4800

Other identifiers 1

IdentifierTypeStateIssuer
170720MedicaidOR

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

LicenseStateTypeSpecialty
MD14048ORMDObstetrics & Gynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730199720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 NW 22ND AVE",
            "address_2": "STE 520",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102976",
            "telephone_number": "503-274-4800",
            "fax_number": "503-274-4917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 NW 22ND AVE",
            "address_2": "STE 520",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102976",
            "telephone_number": "503-274-4800",
            "fax_number": "503-274-4917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVANDA",
        "first_name": "CAROLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OR",
            "license": "MD14048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170720",
            "state": "OR"
        }
    ],
    "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 Jul 8, 2007; 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.