Active NPI
William Patrick Brown, D.O.
- Family Medicine Physician
- Portland, OR
National Provider Identifier
1811102486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- DO15219
- Practice address
- 5536 SE Woodstock Blvd
Portland, OR 97206-6829 - Phone
- (503) 236-1830
- Fax
- (503) 236-1908
- NPI assigned
- May 14, 2007
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | DO15219 | OR | Primary |
Addresses
Primary practice location
5536 SE Woodstock Blvd
Portland, OR 97206-6829
Mailing address
5536 SE Woodstock Blvd
Portland, OR 97206-6829
Phone (503) 236-1830
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 031059 | Medicaid | OR |
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
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO15219 | OR | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1811102486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5536 SE WOODSTOCK BLVD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972066829",
"telephone_number": "503-236-1830",
"fax_number": "503-236-1908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5536 SE WOODSTOCK BLVD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972066829",
"telephone_number": "503-236-1830",
"fax_number": "503-236-1908"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "WILLIAM",
"middle_name": "PATRICK",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "DO15219",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "031059",
"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.