Genesis Medical Group II, Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

GENESIS MEDICAL GROUP II, INC

Practice address

10802 SE Washington St
Portland, OR 97216-3118

Phone

(503) 231-1529

Fax

(503) 231-7805

NPI assigned

Jun 26, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Wyatt James Brown, C.PED.

Title

Director of Operation

Phone

(503) 231-1529

Specialties & licenses 2

Addresses

Other identifiers 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Hanger Prosthetics & Orthotics Inc

  • Prosthetic/Orthotic Supplier
  • Gainesville, GA
  • NPI 1659443380

  Member Of

  NPD member

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340841600000",
    "number": "1790712073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10802 SE WASHINGTON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972163118",
            "telephone_number": "503-231-1529",
            "fax_number": "503-231-7805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10802 SE WASHINGTON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972163118",
            "telephone_number": "503-231-1529",
            "fax_number": "503-231-7805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS MEDICAL GROUP II, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2012-06-28",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "WYATT",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATION",
        "authorized_official_telephone_number": "503-231-1529",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "C.PED."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123617",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Lee Gendreau, MD
• Kathleen Gendron, DPT
• Maru Genemo
• General and Vascular Surgery
• Generations Family Medicine, Professional Corporation
• Genesis Medical Group LLC
• Genesis Medical Group, LLC.
• Geoff Geness, D.C., LAC.
• Maryann Geness, D.C.
• Genevieve Johnson Lac LLC

• Prosthetic/Orthotic Supplier in Portland, OR
• Providers in Portland, OR by specialty
• Prosthetic/Orthotic Supplier in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2012; 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.