Children's Community Clinic

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

CHILDREN'S COMMUNITY CLINIC

Practice address

2250 Lloyd Ctr
Portland, OR 97232-1311

Phone

(503) 284-5239

Fax

(503) 284-9162

NPI assigned

Aug 20, 2007

Organization subpart

No

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

Authorized official

Name

Mardica Hicks

Title

Ceo

Phone

(503) 284-5239

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21002/brand/1/csg/1/fhir/r4

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark S. Lindau, M.D.

  • Pediatrics Physician
  • Portland, OR
  • NPI 1962589226
  NPD (past)
• Robert Henry Schwartz, MD

  • Allergy Physician
  • Portland, OR
  • NPI 1568482610
  NPD (past)

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

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623196800000",
    "number": "1841483252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 LLOYD CTR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321311",
            "telephone_number": "503-284-5239",
            "fax_number": "503-284-9162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 LLOYD CTR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321311",
            "telephone_number": "503-284-5239",
            "fax_number": "503-284-9162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S COMMUNITY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-20",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "MARDICA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "503-284-5239"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500612895",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tanis Yat-Kai Chik, L.AC., L.M.T.
• Gilbert C Child, MD
• David Courtland Childers, MD
• Michelle Childers, PWS, THW
• Jana Marie Childes, MS, CCC-SLP
• Children's Developmental Health Institute (Hearing Institute)
• Children's Intensive Therapy
• Children's Naturopathic Centre PC
• Children's Nursing Specialties, Inc.
• Children's Program

• Pediatrics Physician in Portland, OR
• Providers in Portland, OR by specialty
• Pediatrics Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; 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.