NPIMap

Organization Active NPI

Oregon City Medical NW Inc.

  • Family Medicine Physician
  • Oregon City, OR
National Provider Identifier
1922209832
Registry record updated Oct 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
OREGON CITY MEDICAL NW INC.
Practice address
728 Molalla Ave Ste a&B
Oregon City, OR 97045-2799
Phone
(503) 656-9030
Fax
(503) 656-9026
NPI assigned
May 29, 2007
Last updated
Oct 31, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2014

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

Authorized official

Name
Mrs. Danielle L BlackwellNPI 1366400293
Title
Owner
Phone
(503) 656-9030

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Family Planning Facility 261QA0005X
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

728 Molalla Ave Ste a&B
Oregon City, OR 97045-2799

Mailing address

728 Molalla Ave Ste a&B
Oregon City, OR 97045-2799
Phone (503) 656-9030

Other identifiers 2

IdentifierTypeStateIssuer
838553000OtherORBLUE CROSS GROUP ID
218463MedicaidOR

National Provider Directory

National Provider Directory

Locations

728 Molalla Ave
Ste Ab
Oregon City, OR 97045
Phone (503) 656-9030

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414713600000",
    "number": "1922209832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 MOLALLA AVE STE A&B",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970452799",
            "telephone_number": "503-656-9030",
            "fax_number": "503-656-9026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 MOLALLA AVE STE A&B",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970452799",
            "telephone_number": "503-656-9030",
            "fax_number": "503-656-9026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON CITY MEDICAL NW INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2014-10-31",
        "status": "A",
        "authorized_official_last_name": "BLACKWELL",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-656-9030",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA0005X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Family Planning Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP ID",
            "identifier": "838553000",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218463",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2014; 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.