NPIMap

Organization Active NPI

Northwest Medical, LLC.

  • Oxygen Equipment & Supplies (DME)
  • Clackamas, OR
National Provider Identifier
1770539603
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
Legal business name
NORTHWEST MEDICAL, LLC.
Practice address
14200 SE 98TH
#100
Clackamas, OR 97015-6615
Phone
(503) 234-6219
Fax
(503) 234-6521
NPI assigned
May 25, 2006
Last updated
Jan 26, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
GREAT ELM HEALTHCARE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Authorized official

Name
Gregory J Crawford
Title
President
Phone
(859) 441-8876

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Oxygen Equipment & Supplies (DME) 332BX2000X NU Primary

Addresses

Primary practice location

14200 SE 98TH
#100
Clackamas, OR 97015-6615

Mailing address

2330 W Broadway Rd Ste 107
Mesa, AZ 85202-1886
Phone (480) 830-7700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930078579 OR DME Supplier - Medical Supply CompanyDME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Oxygen & Equipment 4183744196 Practice locations: Clackamas, OR

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Northwest Medical LLC14200 SE 98TH CT, Clackamas, OR 97015-6615(503) 234-6219 Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Gastric Suction Pumps|Heat & Cold Applications|Hospital Beds (Electric)|Hospital Beds (Manual)|Negative Pressure Wound Therapy Pumps/Supplies|Neuromuscular Elect Stimulators (NME… Does not accept assignmentParticipating since Jan 1, 2001

National Provider Directory

National Provider Directory
Tax ID family
Northwest Medical LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1010 SE Stark St
Portland, OR 97214
Phone (503) 234-6219

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": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674691200000",
    "number": "1770539603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 W BROADWAY RD STE 107",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852021886",
            "telephone_number": "480-830-7700",
            "fax_number": "480-750-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14200 SE 98TH",
            "address_2": "#100",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970156615",
            "telephone_number": "503-234-6219",
            "fax_number": "503-234-6521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST MEDICAL, LLC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GREAT ELM HEALTHCARE, LLC",
        "enumeration_date": "2006-05-25",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A",
        "authorized_official_last_name": "CRAWFORD",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "859-441-8876"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.