Northwest Extremity Specialists LLC

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

Legal business name

NORTHWEST EXTREMITY SPECIALISTS LLC

Practice address

6542 SE Lake Rd Ste 102
Milwaukie, OR 97222-2245

Phone

(503) 659-6686

Fax

(503) 905-6202

NPI assigned

Mar 11, 2021

Last updated

Mar 11, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

NORTHWEST EXTREMITY SPECIALISTS LLCAs reported in NPPES

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

Authorized official

Name

Thomas Charles Melillo, DPMNPI 1619085479

Title

Owner

Phone

(503) 245-2420

Specialties & licenses 1

Addresses

Other names 1

• NES Milwaukie Other name

Part of

Northwest Extremity Specialists LLC

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.

• Thomas Charles Melillo, DPM

  • Foot & Ankle Surgery Podiatrist
  • Portland, OR
  • NPI 1619085479
  Authorized official Same address or phone

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

{
    "created_epoch": "1615420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615420800000",
    "number": "1841875770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9115 SW OLESON RD STE 205",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972236877",
            "telephone_number": "503-245-2420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6542 SE LAKE RD STE 102",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972222245",
            "telephone_number": "503-659-6686",
            "fax_number": "503-905-6202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST EXTREMITY SPECIALISTS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHWEST EXTREMITY SPECIALISTS LLC",
        "enumeration_date": "2021-03-11",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A",
        "authorized_official_last_name": "MELILLO",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-245-2420",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NES Milwaukie",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mark D Nordlund, PSY.D.
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• Northwest ENT, Allergy and Sleep Associates, LLC
• Northwest Housing Alternatives
• Northwest Natural Medicine, LLC
• Northwest Neurology Clinic
• Northwest Primary Care Group PC
• Northwest Primary Care Group PC

• Podiatric Clinic/Center in Milwaukie, OR
• Providers in Milwaukie, OR by specialty
• Podiatric Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.