Individual provider Active NPI

Michelle Cameron Welborn, MD

  • Orthopaedic Surgery Physician
  • Portland, OR
National Provider Identifier
1821257718
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD172704 Issued in OR
Practice address
3101 SW Sam Jackson Park Road
Portland, OR 97239-3009
Phone
(503) 221-3424
Fax
(503) 221-3490
NPI assigned
Jun 5, 2008
Last updated
Mar 25, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD172704 OR Primary

Addresses

Primary practice location

3101 SW Sam Jackson Park Road
Portland, OR 97239-3009

Mailing address

PO Box 8500, Lockbox 7642
Philadelphia, PA 19178-7642
Phone (813) 281-8115

Other identifiers 1

IdentifierTypeStateIssuer
MD172704OtherORSTATE LICENSE

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address mwelborn735833@oc.providencedirect.org
Direct Messaging Address mwelborn735833@oc.providencedirect.org
Direct Messaging Address mwelborn735833@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161205001058 OR Practitioner - Orthopedic Surgery 4082838321 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD172704ORMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Current Accepting new patients
University Professional Services CurrentSince Oct 29, 2016 Accepting new patients
Shriners Hospitals for Children CurrentSince Sep 9, 2023 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jul 15, 2016 Accepting new patients
University Professional Services CurrentSince Oct 29, 2016 Accepting new patients
University Professional Services Current Accepting new patients
Providence Health & Services Oregon CurrentSince Jul 1, 2016 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jul 15, 2016 Accepting new patients
Shriners Hospitals for Children Past Accepting new patients
Shriners Hospitals for Children Past Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

3101 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 221-3424

3101 SW Sam Jackson Park Rd
#R
Portland, OR 97239
Phone (503) 241-5090

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

9155 SW Barnes Rd
Ste 211
Portland, OR 97225
Phone (503) 216-6050

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

9427 SW Barnes Rd
Ste 395
Portland, OR 97225
Phone (503) 216-2602

9427 SW Barnes Rd
Ste 598
Portland, OR 97225
Phone (503) 215-8690

Interoperability endpoints

  • Direct secure messaging: mwelborn735783@ak.providencedirect.org
  • Direct secure messaging: mwelborn98071@direct.ohsu.edu

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1821257718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8500, LOCKBOX 7642",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191787642",
            "telephone_number": "813-281-8115",
            "fax_number": "813-281-8656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 SW SAM JACKSON PARK ROAD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393009",
            "telephone_number": "503-221-3424",
            "fax_number": "503-221-3490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELBORN",
        "first_name": "MICHELLE",
        "middle_name": "CAMERON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-05",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OR",
            "license": "MD172704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MD172704",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwelborn735833@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9155 SW Barnes Rd Ste 211",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972256629",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwelborn735833@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9427 SW Barnes Rd Ste 395",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972256652",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwelborn735833@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9427 SW Barnes Rd Ste 598",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972256652",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.