Cornell Urgent Care

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

MD22180 Issued in OR

Legal business name

CORNELL URGENT CARE

Practice address

12325 SW Horizon Blvd Unit 225
Beaverton, OR 97007-9474

Phone

(503) 747-0120

NPI assigned

Jan 25, 2012

Last updated

Jan 25, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sejung Shin, M.D.

Title

President

Phone

(503) 747-0120

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Cornell Urgent Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Cornell Urgent Care

  • Urgent Care Clinic/Center
  • Oregon City, OR
  • NPI 1639449317
  NPD tax ID

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

{
    "created_epoch": "1327449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327449600000",
    "number": "1871864603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12325 SW HORIZON BLVD UNIT 225",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970079474",
            "telephone_number": "503-747-0120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12325 SW HORIZON BLVD UNIT 225",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970079474",
            "telephone_number": "503-747-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNELL URGENT CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-25",
        "last_updated": "2012-01-25",
        "status": "A",
        "authorized_official_last_name": "SHIN",
        "authorized_official_first_name": "SEJUNG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-747-0120",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "OR",
            "license": "MD22180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024277",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Corbin
• Kristen Corbin, BDC.BD.70136630
• Rachel Mehana Cordery, LMT
• Cornell Pain Clinic (Suresh Chand MD)
• Cornell Pain Clinic LLC (Suresh Chand MD)
• Cornerstone Caregiving, Inc (Home Instead #352)
• Maddelyne Mishell Corrales
• Michelle K Correia-Jeffers, DPT
• Cory Correia
• Nathaniel Correia, PT

• Urgent Care Clinic/Center in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Urgent Care Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.