NPIMap

Organization Active NPI

Craig Hertler MD LLC

  • Specialist
  • Portland, OR
National Provider Identifier
1952355893
Registry record updated Feb 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD14722 Issued in OR
Legal business name
CRAIG HERTLER MD LLC
Practice address
2222 NW Lovejoy
#607
Portland, OR 97210
Phone
(503) 222-3638
NPI assigned
May 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2012

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

Authorized official

Name
Dr. Craig K. Hertler, M.D.
Title
Owner/Physician
Phone
(503) 222-3638

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X MD14722 OR Primary

Addresses

Primary practice location

2222 NW Lovejoy
#607
Portland, OR 97210

Mailing address

2222 NW Lovejoy
#607
Portland, OR 97210
Phone (503) 222-3638

Other identifiers 1

IdentifierTypeStateIssuer
012893MedicaidOR

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328745600000",
    "number": "1952355893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 NW LOVEJOY",
            "address_2": "#607",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97210",
            "telephone_number": "503-222-3638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 NW LOVEJOY",
            "address_2": "#607",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97210",
            "telephone_number": "503-222-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAIG HERTLER MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2012-02-09",
        "status": "A",
        "authorized_official_last_name": "HERTLER",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "503-222-3638",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OR",
            "license": "MD14722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012893",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.