Active NPI
Berton H Stone, M.D.
- Internal Medicine Physician
- Lake Oswego, OR
National Provider Identifier
1740394857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD20410
- Practice address
- 17704 Jean Way
Suite 105
Lake Oswego, OR 97035-5497 - Phone
- (503) 675-6776
- Fax
- (503) 675-2572
- NPI assigned
- Aug 18, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD20410 | OR | Primary |
Addresses
Primary practice location
17704 Jean Way
Suite 105
Lake Oswego, OR 97035-5497
Mailing address
20365 SE Alder Spring CT
Damascus, OR 97009-9346
Phone (503) 658-7713
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 |
|---|---|---|---|
| MD20410 | OR | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1740394857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20365 SE ALDER SPRING CT",
"city": "DAMASCUS",
"state": "OR",
"postal_code": "970099346",
"telephone_number": "503-658-7713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17704 JEAN WAY",
"address_2": "SUITE 105",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970355497",
"telephone_number": "503-675-6776",
"fax_number": "503-675-2572"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STONE",
"first_name": "BERTON",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OR",
"license": "MD20410",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lake Oswego, 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.