NPIMap

Organization Active NPI

Specialty Neuro, P.C.

  • Specialist
  • Portland, OR
National Provider Identifier
1962543256
Registry record updated Nov 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD22182 Issued in OR
Legal business name
SPECIALTY NEURO, P.C.
Practice address
1800 NE 2ND Ave
Portland, OR 97212-3932
Phone
(503) 579-5000
Fax
(503) 579-5000
NPI assigned
Feb 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2007

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

Authorized official

Name
Dr. David Alan Siker, M.D.
Title
Physician Director
Phone
(503) 579-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X MD22182 OR Primary

Addresses

Primary practice location

1800 NE 2ND Ave
Portland, OR 97212-3932

Mailing address

PO Box 219009
Portland, OR 97225-9009
Phone (503) 579-5000

Other identifiers 1

IdentifierTypeStateIssuer
286534MedicaidOR

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195603200000",
    "number": "1962543256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 219009",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972259009",
            "telephone_number": "503-579-5000",
            "fax_number": "503-579-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 NE 2ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972123932",
            "telephone_number": "503-579-5000",
            "fax_number": "503-579-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY NEURO, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2007-11-21",
        "status": "A",
        "authorized_official_last_name": "SIKER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PHYSICIAN DIRECTOR",
        "authorized_official_telephone_number": "503-579-5000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OR",
            "license": "MD22182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286534",
            "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 Nov 21, 2007; 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.