PORTLAND FOOT AND ANKLE INSTITUTE, LLC (NPI# 1124507827) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1124507827 |
Entity Type | Organization |
Organization Name | PORTLAND FOOT AND ANKLE INSTITUTE, LLC |
Practice Address |
12672 Nw Barnes Rd Ste 100 Portland OR 97229-6191 |
Mailing Address |
10690 Ne Cornell Rd Ste 212 Hillsboro OR 97124-9224 |
Practice Telephone | 5033360169 |
Practice Fax Number | 5033524583 |
Enumeration Date | 2018-08-13 |
Last Update Date | 2019-07-30 |
Authorized Official Name | DR. MICHAEL ALBERT GENTILE (PRESIDENT) |
Authorized Official Telephone | 5035363074 |
Authorized Official Credential | DPM |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
DP00371 | OR | Podiatric Medicine & Surgery Service Providers |
Street Address |
12672 NW BARNES RD STE 100 |
City | PORTLAND |
State | OR |
Zip Code | 97229-6191 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356305023 | David N Westerdahl | Family Medicine | 12672 Nw Barnes Rd Ste 100, Portland, OR 97229-6191 | 2006-04-12 |
1346863727 | Sports Health Northwest Inc | Family Medicine | 12672 Nw Barnes Rd Ste 100, Portland, OR 97229-6191 | 2020-05-20 |
1255547782 | Maureen Shenker | Physician Assistant | 12672 Nw Barnes Rd Ste 100, Portland, OR 97229-6191 | 2007-05-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851919906 | Anjana Rajan | Counselor | Lifeworks Northwest, 14600 Nw Cornell Rd, Portland, OR 97229 | 2020-07-06 |
1871138453 | Kedrick Starr | Case Manager/Care Coordinator | 14600 Nw Cornell Rd., Portland, OR 97229 | 2019-11-07 |
1477102689 | Raquel A Bishop | Nurse Practitioner | 12400 Nw Cornell Rd Ste 100, Portland, OR 97229 | 2019-09-10 |
1669026134 | Alexandra Elizabeth Lodwig | Speech-Language Pathologist | 255 Nw Lost Springs Terrace Apt 304, Portland, OR 97229 | 2019-08-01 |
1003316043 | Jenny Lavonne Thom | Counselor | 15220 Nw Laidlaw Rd., Suite 280, Portland, OR 97229 | 2018-02-16 |
1194230664 | Ankita Guchait | Case Manager/Care Coordinator | 14600 Nw Cornell Rd, Portland, OR 97229 | 2017-12-06 |
1568988913 | Hannah Hendrix Klingelheber | Speech-Language Pathologist | 15605 Nw Ryegrass St., Portland, OR 97229 | 2017-08-17 |
1548791213 | Adeline Mitchell | Registered Nurse | 14600 Sw Cornell Rd., Portland, OR 97229 | 2017-03-24 |
1538610670 | Crystal Graves | Peer Specialist | 14600 Nw Cornell, Portland, OR 97229 | 2016-10-24 |
1639533185 | Evelin James | Dental Hygienist | 5879 Nw Lark Meadow Ter, Portland, OR 97229 | 2016-04-11 |
Find all providers in zip 97229 |
Taxonomy Code | 213ES0103X |
Grouping | Podiatric Medicine & Surgery Service Providers |
Classification | Podiatrist |
Specialization | Foot & Ankle Surgery |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386051803 | Southwest Podiatry Center LLC | Podiatrist | 9370 Sw Greenburg Rd Ste 102, Portland, OR 97223-5428 | 2014-07-16 |
1386884237 | Lopa Dalmia | Podiatrist | 12400 Nw Cornell Rd Ste 201, Portland, OR 97229-5689 | 2009-03-04 |
1679743876 | Brandi S. Myers Dpm, LLC | Podiatrist | 7836 Se 13th Ave, Portland, OR 97202-6350 | 2008-03-04 |
1093921975 | Brian M. Bowen | Podiatrist | 1717 Ne 42nd Ave, Suite 3300, Portland, OR 97213-1569 | 2007-05-15 |
1689700486 | Brandi Sue Myers | Podiatrist | 5225 Se 28th Ave, Portland, OR 97202-4506 | 2007-02-26 |
1255440020 | Gina M Bullock | Podiatrist | 3508 Ne Broadway St, Portland, OR 97232-1821 | 2006-08-29 |
1982647467 | Thomas R Palmer | Podiatrist | 6108 Ne Glisan St, Portland, OR 97213-3864 | 2006-06-13 |
1962454934 | Clifford Donald Mah | Podiatrist | 12400 Nw Cornell Rd, Suite 201, Portland, OR 97229-5693 | 2006-05-17 |
1538149471 | Christopher Gerard Pingitore | Podiatrist | 51 Sewall St Ste 2, Portland, ME 04102-2644 | 2006-01-18 |
1194705038 | John Henry Dorsey Jr. | Podiatrist | 195 Fore River Parkway, Suite 120, Portland, ME 04102 | 2006-01-18 |
Find all providers in PORTLAND |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.