CODY MACMILLAN (NPI# 1578906525) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578906525 |
| Entity Type | Individual |
| Full Name | CODY MACMILLAN |
| Credential | M.D. |
| Practice Address |
10180 Se Sunnyside Rd Clackamas OR 97015-8970 |
| Mailing Address |
5014 Ne 36th Ave Portland OR 97211-7624 |
| Practice Telephone | 5038132000 |
| Mailing Telephone | 5413000262 |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2020-10-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
MD190214 | OR | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2801 N Gantenbein Ave, Portland, OR 972271623 | 5034134692 |
| Street Address |
10180 SE SUNNYSIDE RD |
| City | CLACKAMAS |
| State | OR |
| Zip Code | 97015-8970 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407855786 | Kevin C La Cour | Radiology | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2005-07-19 |
| 1588270466 | Jacob Aaron Stutheit | Student in an Organized Health Care Education/Training Program | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-09-16 |
| 1023633005 | Jeremy Ward | Student in an Organized Health Care Education/Training Program | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-06-15 |
| 1336761998 | Maksim Ivan Yablonsky | Technician, Other | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-05-17 |
| 1497389811 | Clifford Andrew Moore | Student in an Organized Health Care Education/Training Program | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-02-25 |
| 1417580622 | Taryn Dee | Surgery | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-02-16 |
| 1881225241 | Jocelyn Mason | Pharmacist | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-02-03 |
| 1760022461 | Katie Keim | Social Worker | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-01-09 |
| 1346887668 | Hannah N. Schroeder | Registered Nurse | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2019-12-05 |
| 1164072286 | Thien-huong Theresa Van | Student in an Organized Health Care Education/Training Program | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2019-09-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184103517 | Laurel Perilli | Physical Therapist | 12550 Se 93rd Ave Ste 265, Clackamas, OR 97015 | 2018-08-07 |
| 1306324538 | Kristin Connor Messing | Physical Therapist | 4805 Ne Glisan St, Prov Hall 7e06, Portland, OR 97015 | 2018-07-31 |
| 1902317266 | Darcy Jones Hamrick | Counselor | 12901 Se 97th Ave., Suite 340, Clackamas, OR 97015 | 2017-10-13 |
| 1841723384 | Manon Lavoie | Chiropractor | 17105 Se Sunnyside Rd, Suite 148, Happy Valley, OR 97015 | 2017-04-11 |
| 1235670126 | Michael G Short | Pedorthist | 10117 Se Sunnyside Rd., Ste. H, Clackamas, OR 97015 | 2017-03-13 |
| 1487100756 | Michael Joseph Peizner | Pharmacist | 16300se Evelyn Street, Clackamas, OR 97015 | 2016-08-28 |
| 1316395619 | Jennifer Elaine Walkowski | Physical Therapist | 9100 Se Sunnyside Road, Clackamas, OR 97015 | 2016-05-26 |
| 1649635384 | Brookside Dental - Milwaukie, LLC | Dentist | 9225 Se Sunnyside Rd. Ste 1, Clackamas, OR 97015 | 2015-12-23 |
| 1801216130 | Robert D. Grew Dmd, Inc. | Dentist | 10163 Se Sunnyside Road, Suite 414, Clackamas, OR 97015 | 2014-04-25 |
| 1508205410 | Valerie P Tabalno | Massage Therapist | 15661 Se 82nd Dr, Clackamas, OR 97015 | 2013-06-25 |
| Find all providers in zip 97015 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114020054 | Gordon Adair Stoney | Radiology | 10180sesunnysiderd, Clackamas, OR 97015-9764 | 2006-09-06 |
| 1497702062 | Brian Lynn Dunkley | Radiology | Kaiser Sunnyside Medical Office, 10180 Se Sunnyside Rd, Clackamas, OR 97015-9764 | 2006-05-28 |
| 1558345355 | Douglas Eisenberg | Radiology | Kaiser Sunnyside Medical Center, 10180 Se Sunnyside Rd, Clackamas, OR 97015-9764 | 2005-12-05 |
| 1750374922 | Bodyview Advanced Diagnostic Scanning, LLC | Radiology | 13540 Se 97th Ave, Clackamas, OR 97015-7691 | 2005-08-23 |
| 1407855786 | Kevin C La Cour | Radiology | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2005-07-19 |
| 1104132497 | Clay Anthony Elrod | Radiology | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2010-08-24 |
| 1134330285 | Joshua Robert Hill | Radiology | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2007-05-24 |
| 1558581629 | Alfredo Luis Arraut | Radiology | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2007-04-30 |
| 1154465482 | Jerry Everett King | Radiology | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2007-02-19 |
| 1538202510 | David Leo Klein | Radiology | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2007-02-15 |
| Find all providers in CLACKAMAS | ||||
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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.