Active NPI
Clifton A. J. Edwards, MHA,REEGT,PMP, CPHQ
- EEG Specialist/Technologist
- Portland, OR
National Provider Identifier
1760856231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- EEG Specialist/Technologist
- License
- #3283: R. EEG T.
- Practice address
- 3347 NE 164TH Loop
Portland, OR 97230-5063 - Phone
- (971) 227-9340
- NPI assigned
- Nov 21, 2015
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| EEG Specialist/Technologist | 246ZE0500X | #3283: R. EEG T. | Primary | |
| Other Specialist/Technologist | 246Z00000X | #847: R. EP T. | ||
| Other Specialist/Technologist | 246Z00000X | #3726: RPSGT | ||
| Electroneurodiagnostic Specialist/Technologist | 246ZE0600X |
Addresses
Primary practice location
3347 NE 164TH Loop
Portland, OR 97230-5063
Mailing address
3439 NE Sandy Blvd # 367
Portland, OR 97232-1959
Phone (971) 227-9340
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)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| In Home Neuro Studies LLC | Eeg | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1448064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488240000000",
"number": "1760856231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3439 NE SANDY BLVD # 367",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972321959",
"telephone_number": "971-227-9340",
"fax_number": "864-364-5280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3347 NE 164TH LOOP",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972305063",
"telephone_number": "971-227-9340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "CLIFTON",
"middle_name": "A. J.",
"credential": "MHA,REEGT,PMP, CPHQ",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-11-21",
"last_updated": "2017-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "246ZE0500X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, EEG",
"state": null,
"license": "#3283: R. EEG T.",
"primary": true
},
{
"code": "246Z00000X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other",
"state": null,
"license": "#847: R. EP T.",
"primary": false
},
{
"code": "246Z00000X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other",
"state": null,
"license": "#3726: RPSGT",
"primary": false
},
{
"code": "246ZE0600X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"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 Feb 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.