Columbia Pain and Spine Institute

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

38D2018576 Issued in OR

Legal business name

COLUMBIA PAIN AND SPINE INSTITUTE

Practice address

831 NW Council Dr
#300
Gresham, OR 97030

Phone

(503) 382-8100

Fax

(503) 382-8120

NPI assigned

Oct 23, 2012

Last updated

Oct 23, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

COLUMBIA PAIN AND SPINE INSTITUTEAs reported in NPPES

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

Authorized official

Name

Mrs. Pamela J Blanchard

Title

Business Office MGR

Phone

(503) 382-8152

Specialties & licenses 1

Addresses

Other identifiers 2

Part of

Columbia Pain and Spine Institute

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Columbia Pain and Spine Institute

  • Physical Medicine & Rehabilitation Physician
  • Gresham, OR
  • NPI 1972813962
  NPPES parent name

Practitioners 1

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.

• Oleg Maksimov, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Gresham, OR
  • NPI 1780796326
  NPD

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

{
    "created_epoch": "1350950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350950400000",
    "number": "1821341223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "831 NW COUNCIL DR",
            "address_2": "#300",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "97030",
            "telephone_number": "503-382-8100",
            "fax_number": "503-382-8120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 NW COUNCIL DR",
            "address_2": "#300",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "97030",
            "telephone_number": "503-382-8100",
            "fax_number": "503-382-8120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA PAIN AND SPINE INSTITUTE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLUMBIA PAIN AND SPINE INSTITUTE",
        "enumeration_date": "2012-10-23",
        "last_updated": "2012-10-23",
        "status": "A",
        "authorized_official_last_name": "BLANCHARD",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "BUSINESS OFFICE MGR",
        "authorized_official_telephone_number": "503-382-8152",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "OR",
            "license": "38D2018576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "00851",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500632340",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina H Collier, QMHA-I
• Kathryn Collins, DPT
• Stephanie Collins, BA IN PSYCHOLOGY
• Sandra Ann Collis, DO
• Columbia Medical and Endocrine Clinic
• Columbia Pain and Spine Institute
• Columbia River Dentistry-Gresham, LLC
• Columbia Surgical Specialists PLLC
• Tyrell Anthony Comeaux, MS, RD
• Complete Eye Care, Inc.

• Clinical Medical Laboratory in Gresham, OR
• Providers in Gresham, OR by specialty
• Clinical Medical Laboratory in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.