NPIMap

Organization Active NPI

Physicians Medical Center, P C

Doing business as Physicians Medical Center, Lab

  • Clinical Medical Laboratory
  • McMinnville, OR
National Provider Identifier
1821035841
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
38D0622888 Issued in OR
Legal business name
PHYSICIANS MEDICAL CENTER, P C
Doing business as
Physicians Medical Center, Lab
Practice address
2435 NE Cumulus Ave Ste a
McMinnville, OR 97128-8862
Phone
(503) 472-6161
Fax
(503) 434-8498
NPI assigned
May 31, 2006
Last updated
Sep 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Authorized official

Name
Kathy J Craig
Title
Credentialing
Phone
(503) 758-4135

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 38D0622888 OR Primary

Addresses

Primary practice location

2435 NE Cumulus Ave Ste a
McMinnville, OR 97128-8862

Mailing address

2435 NE Cumulus Ave Ste a
McMinnville, OR 97128-8862
Phone (503) 472-6161

Other names 1

  • Physicians Medical Center, Lab Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040421000855 OR Part B Supplier - Independent Clinical Laboratory 6305832890 Practice locations: McMinnville, OR

Other NPIs with the same Medicare PAC ID 1

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D0622888Physicians' Medical Center Lab2435 NE Cumulus Ave Suite a, McMinnville, OR 97128ComplianceDec 7, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662940800000",
    "number": "1821035841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2435 NE CUMULUS AVE STE A",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971288862",
            "telephone_number": "503-472-6161",
            "fax_number": "503-434-8498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 NE CUMULUS AVE STE A",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971288862",
            "telephone_number": "503-472-6161",
            "fax_number": "503-434-8498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS MEDICAL CENTER, P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A",
        "authorized_official_last_name": "CRAIG",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "503-758-4135"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "OR",
            "license": "38D0622888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physicians Medical Center, Lab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Physicians Medical Center, Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in McMinnville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; 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.