NPIMap

Organization Active NPI

Orthopedic & Fracture Clinic PC

  • Orthopaedic Surgery Physician
  • Portland, OR
National Provider Identifier
1871050153
Registry record updated Feb 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ORTHOPEDIC & FRACTURE CLINIC PC
Practice address
11782 SW Barnes Rd Ste 300
Portland, OR 97225-5933
Phone
(503) 214-5200
Fax
(503) 906-6613
NPI assigned
Feb 22, 2019
Last updated
Feb 22, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
ORTHOPEDIC & FRACTURE CLINIC, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 22, 2019

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

Authorized official

Name
J Brad V Butler V, MD
Title
President
Phone
(503) 214-5200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X Primary

Addresses

Primary practice location

11782 SW Barnes Rd Ste 300
Portland, OR 97225-5933

Mailing address

11782 SW Barnes Rd Ste 200
Portland, OR 97225-5931
Phone (503) 906-4302

Other practice location 1

14795 SW Murray Scholls Dr Ste 109
Beaverton, OR 97007-9230
Phone (503) 214-5200

Other identifiers 1

IdentifierTypeStateIssuer
146456MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040405000622 OR Part B Supplier - Clinic/Group Practice 1052219953 Receives reassigned benefits from 60 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Beaverton, OR; Portland, OR

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Orthopedic Fracture Clinic

Locations

11782 SW Barnes Rd
Ste 100
Portland, OR 97225
Phone (503) 214-5200

Ownership & related parties

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.

Practitioners & affiliated clinicians

Practitioners 50

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.

View all 50

NPI Registry JSON

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

{
    "created_epoch": "1550793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550793600000",
    "number": "1871050153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11782 SW BARNES RD STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255931",
            "telephone_number": "503-906-4302",
            "fax_number": "503-840-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11782 SW BARNES RD STE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255933",
            "telephone_number": "503-214-5200",
            "fax_number": "503-906-6613"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14795 SW Murray Scholls Dr Ste 109",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970079230",
            "country_code": "US",
            "telephone_number": "503-214-5200",
            "fax_number": "503-906-6613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ORTHOPEDIC & FRACTURE CLINIC PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ORTHOPEDIC & FRACTURE CLINIC, PC",
        "enumeration_date": "2019-02-22",
        "last_updated": "2019-02-22",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "J BRAD",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-214-5200",
        "authorized_official_name_suffix": "V",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146456",
            "state": "OR"
        }
    ],
    "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 Feb 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.