NPIMap

Organization Active NPI

Kids First Pediatric Clinic LLC

  • Pediatrics Physician
  • West Linn, OR
National Provider Identifier
1902144298
Registry record updated Jan 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD28575 Issued in OR
Legal business name
KIDS FIRST PEDIATRIC CLINIC LLC
Practice address
18603 Willamette Dr
West Linn, OR 97068-1705
Phone
(503) 730-1634
NPI assigned
Jan 22, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2013

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

Authorized official

Name
Badia Jabbour, MDNPI 1508863358
Title
Owner/MD
Phone
(503) 730-1634

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X MD28575 OR Primary

Addresses

Primary practice location

18603 Willamette Dr
West Linn, OR 97068-1705

Mailing address

18603 Willamette Dr
West Linn, OR 97068-1705

National Provider Directory

National Provider Directory

Locations

1673 10th St
West Linn, OR 97068
Phone (503) 305-7231

18676 Willamette Dr
Ste 300
West Linn, OR 97068
Phone (503) 699-3313

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1358812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358812800000",
    "number": "1902144298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18603 WILLAMETTE DR",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970681705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18603 WILLAMETTE DR",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970681705",
            "telephone_number": "503-730-1634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS FIRST PEDIATRIC CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-22",
        "last_updated": "2013-01-22",
        "status": "A",
        "authorized_official_last_name": "JABBOUR",
        "authorized_official_first_name": "BADIA",
        "authorized_official_title_or_position": "OWNER/MD",
        "authorized_official_telephone_number": "503-730-1634",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD28575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Linn, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2013; 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.