Keith Douglas Balderston, MD

Primary specialty

Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X

License

MD60748459 Issued in WA

Practice address

3355 Riverbend Dr
Ste 210
Springfield, OR 97477-8800

Phone

(541) 485-2777

Fax

(541) 246-2353

NPI assigned

Jul 7, 2006

Last updated

May 18, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR, MT, ID, AL, WA, SD6 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 6

Specialty

Obstetrics/Gynecology

Education

Oregon Health Sciences University School of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Origin Health LLCGroup PAC ID 8325465487, 8 clinicians

Womens Care PCGroup PAC ID 8820986458, 38 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21046/brand/1/csg/1/fhir/r4
• Direct secure messaging: kdbalder@yourcarecommunity.org
• Direct secure messaging: keith.balderston.1@21046.direct.athenahealth.com
• Direct secure messaging: keith.balderston@avera.sdhealthlink.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Womens Care, PC

  • Obstetrics & Gynecology Physician
  • Springfield, OR
  • NPI 1144250044

  Maternal & Fetal Medicine

  Medicare reassignment Care Compare group NPD
• Origin Health LLC

  • Maternal & Fetal Medicine Physician
  • Missoula, MT
  • NPI 1841835113
  Medicare reassignment Care Compare group NPD
• Peacehealth

  dba Peace Harbor Medical Center

  • Multi-Specialty Clinic/Center
  • Florence, OR
  • NPI 1982774378
  Medicare reassignment NPD
• Avera McKennan

  dba Avera McKennan Behavioral Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sioux Falls, SD
  • NPI 1699009944
  Medicare reassignment NPD
• The Vancouver Clinic Inc PS

  dba The Vancouver Clinic

  • Internal Medicine Physician
  • Vancouver, WA
  • NPI 1992759427
  Medicare reassignment NPD
• University of South Alabama

  dba USA Student Health Center

  • Family Medicine Physician
  • Mobile, AL
  • NPI 1992746838
  Medicare reassignment NPD
• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058
  Medicare reassignment
• Avera McKennan

  dba Avera Interventional Radiology

  • Diagnostic Radiology Physician
  • Sioux Falls, SD
  • NPI 1053680678
  NPD
• Avera McKennan

  dba Avera Maternal Fetal Medicine Sioux Falls

  • Maternal & Fetal Medicine Physician
  • Sioux Falls, SD
  • NPI 1205808748
  NPD
• The Vancouver Clinic Inc PS

  dba Salmon Creek 2 Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Vancouver, WA
  • NPI 1306556907
  NPD
• The Vancouver Clinic Inc PS

  • Eyewear Supplier
  • Ridgefield, WA
  • NPI 1760004477
  NPD
• University of South Alabama

  • Clinical Medical Laboratory
  • Mobile, AL
  • NPI 1497859052
  NPD

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1871525337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 GAGE BLVD",
            "address_2": "STE 101",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993529532",
            "telephone_number": "541-485-2777",
            "fax_number": "541-246-2353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 RIVERBEND DR",
            "address_2": "STE 210",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974778800",
            "telephone_number": "541-485-2777",
            "fax_number": "541-246-2353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 9th St",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "OR",
            "postal_code": "974397398",
            "country_code": "US",
            "telephone_number": "541-997-8412",
            "fax_number": "541-902-1320",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "340 9th St",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "OR",
            "postal_code": "974399470",
            "country_code": "US",
            "telephone_number": "541-902-1634",
            "fax_number": "541-902-9702",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "333 N 1st St Ste 150",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837026135",
            "country_code": "US",
            "telephone_number": "208-381-3088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALDERSTON",
        "first_name": "KEITH",
        "middle_name": "DOUGLAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "OR",
            "license": "MD18230",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "ID",
            "license": "M-13818",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "WA",
            "license": "MD60748459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "067731",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandi Loraine Baker
• Chelsea Baker, R.D.H
• Kenneth Baker, MD
• Rashell Baker
• Robert Franklin Baker
• Samuel Jackson Balin, M.D., PH.D.
• Lisa Balint-Juilfs
• Jim G Ballard
• Michael R Balm, MD
• Alyssa Baltrusch

• Maternal & Fetal Medicine Physician in Springfield, OR
• Providers in Springfield, OR by specialty
• Maternal & Fetal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.