NPIMap

Organization Active NPI

Kaiser Permanante

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Clackamas, OR
National Provider Identifier
1922559764
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Hospital UnitTaxonomy code 276400000X
Legal business name
KAISER PERMANANTE
Practice address
10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone
(503) 652-2880
NPI assigned
Oct 17, 2016
Last updated
Jun 1, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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

Authorized official

Name
Mr. Alexander Shybut, B.A.NPI 1710339635
Title
Milieu Counselor
Phone
(503) 652-2880

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
Substance Use Disorder Rehabilitation Hospital Unit 276400000X NU Primary

Addresses

Primary practice location

10180 SE Sunnyside Rd
Clackamas, OR 97015-8970

Mailing address

6935 N Richmond Ave
Portland, OR 97203-4933
Phone (503) 728-8581

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

National Provider Directory

National Provider Directory
Tax ID family
Kaiser Permenente150 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 22

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 22

Practitioners & affiliated clinicians

Practitioners 1

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": "1476662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622505600000",
    "number": "1922559764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6935 N RICHMOND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972034933",
            "telephone_number": "503-728-8581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10180 SE SUNNYSIDE RD",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970158970",
            "telephone_number": "503-652-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER PERMANANTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-17",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A",
        "authorized_official_last_name": "SHYBUT",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "MILIEU COUNSELOR",
        "authorized_official_telephone_number": "503-652-2880",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "B.A."
    },
    "taxonomies": [
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10180 SE Sunnyside Rd",
            "city": "Clackamas",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970158970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; 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.