Individual provider Active NPI

Doug Grootveld

  • Acupuncturist
  • Portland, OR
National Provider Identifier
1821316233
Registry record updated May 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC00604 Issued in OR
Practice address
100 NE 78TH Ave
Portland, OR 97213-6335
Phone
(971) 219-7250
NPI assigned
May 10, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC00604 OR Primary

Addresses

Primary practice location

100 NE 78TH Ave
Portland, OR 97213-6335

Mailing address

100 NE 78TH Ave
Portland, OR 97213-6335
Phone (971) 219-7250

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

State licenses

LicenseStateTypeSpecialty
AC00604ORMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1273449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273449600000",
    "number": "1821316233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NE 78TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972136335",
            "telephone_number": "971-219-7250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NE 78TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972136335",
            "telephone_number": "971-219-7250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROOTVELD",
        "first_name": "DOUG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-10",
        "last_updated": "2010-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC00604",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 10, 2010; 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.