Active NPI
Rex Puterbaugh, M.D.
- Pediatrics Physician
- Portland, OR
National Provider Identifier
1952560468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 154607
- Practice address
- 9555 SW Barnes Rd Ste 301
Portland, OR 97225-6670 - Phone
- (503) 297-3371
- NPI assigned
- Jun 9, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 154607 | OR | Primary |
Addresses
Primary practice location
9555 SW Barnes Rd Ste 301
Portland, OR 97225-6670
Mailing address
9555 SW Barnes Rd Ste 301
Portland, OR 97225-6670
Phone (503) 297-3371
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 154607 | OR | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Childrens Clinic PC | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- rputerbaugh18578@direct.lhs.org
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatrics Physician
- Portland, OR
- NPI 1649219411
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622505600000",
"number": "1952560468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9555 SW BARNES RD STE 301",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972256670",
"telephone_number": "503-297-3371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9555 SW BARNES RD STE 301",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972256670",
"telephone_number": "503-297-3371"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUTERBAUGH",
"first_name": "REX",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-09",
"last_updated": "2021-06-01",
"certification_date": "2021-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OR",
"license": "154607",
"primary": true
}
],
"identifiers": [],
"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 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.