Portland Preventive Cardiology LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

MD25708 Issued in OR

Legal business name

PORTLAND PREVENTIVE CARDIOLOGY LLC

Practice address

8855 SW Canyon LN
Portland, OR 97225-3411

Phone

(503) 292-5678

Fax

(503) 292-6665

NPI assigned

Nov 16, 2012

Last updated

Mar 7, 2023By 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. Maureen Ellen Mays, MD, MS, FACC

Title

Sole Member

Phone

(503) 292-5678

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1353024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1912241746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8855 SW CANYON LN",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972253411",
            "telephone_number": "503-292-5678",
            "fax_number": "503-292-6665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8855 SW CANYON LN",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972253411",
            "telephone_number": "503-292-5678",
            "fax_number": "503-292-6665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND PREVENTIVE CARDIOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-16",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "MAYS",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "503-292-5678",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, MS, FACC"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "OR",
            "license": "MD25708",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OR",
            "license": "MD25708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213623",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Primary Care Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.