DR. RICHARD DOUGLAS SOUTHGATE (NPI# 1720303308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720303308 |
| Entity Type | Individual |
| Full Name | DR. RICHARD DOUGLAS SOUTHGATE |
| Credential | M.D. |
| Practice Address |
11782 Sw Barnes Rd Ste 300 Portland OR 97225-5933 |
| Practice Telephone | 5032145200 |
| Practice Fax Number | 5039066613 |
| Mailing Telephone | 5032145200 |
| Mailing Fax Number | 5039066613 |
| Enumeration Date | 2010-04-07 |
| Last Update Date | 2019-08-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 142231 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | OR MEDICAL LICENSE | MD184629 | 01 |
| Street Address |
11782 SW BARNES RD STE 300 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97225-5933 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639284714 | Payton Alan Haynes | Specialist/Technologist | 11782 Sw Barnes Rd Ste 300, The Orthopedic & Fracture Clinic, Portland, OR 97225-5933 | 2006-08-20 |
| 1164037065 | Kelsey Marie Lavaute | Physical Therapist | 11782 Sw Barnes Rd Ste 300, Portland, OR 97225-5933 | 2020-09-09 |
| 1649835273 | Kevin Quangkien Mai | Occupational Therapist | 11782 Sw Barnes Rd Ste 300, Portland, OR 97225-5933 | 2019-05-08 |
| 1871050153 | Orthopedic & Fracture Clinic PC | Orthopaedic Surgery | 11782 Sw Barnes Rd Ste 300, Portland, OR 97225-5933 | 2019-02-22 |
| 1942712047 | Heath L Meir | Physician Assistant | 11782 Sw Barnes Rd Ste 300, Portland, OR 97225-5933 | 2017-10-30 |
| 1336650159 | Kara M Beasley | Physician Assistant | 11782 Sw Barnes Rd Ste 300, Portland, OR 97225-5933 | 2017-10-19 |
| 1902242506 | Jeana Lyn Summers | Neuromusculoskeletal Medicine & OMM | 11782 Sw Barnes Rd Ste 300, Portland, OR 97225-5933 | 2013-05-22 |
| 1447593967 | Hannah Fae Aultman | Orthopaedic Surgery | 11782 Sw Barnes Rd Ste 300, Portland, OR 97225-5933 | 2013-04-03 |
| 1891020673 | Jared Rickard Jones | Physical Therapist | 11782 Sw Barnes Rd Ste 300, Portland, OR 97225-5933 | 2009-10-12 |
| 1780812552 | Ashley H. Carpenter | Physical Therapist | 11782 Sw Barnes Rd Ste 300, Portland, OR 97225-5933 | 2009-06-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508425034 | Gabrielle Gonzales | Behavior Technician | 1675 Sw Marlow Ave, Suite 200, Portland, OR 97225 | 2019-06-08 |
| 1558844555 | Tate Roseberry | Behavior Technician | 1675 Sw Marlow Avenue, Suite 200, Portland, OR 97225 | 2018-09-14 |
| 1982186300 | Dean Alan Hopkins | Registered Nurse | 11782 Sw Barnes Rd, Suite 300, Portland, OR 97225 | 2018-09-01 |
| 1316449168 | Surgery Center At St. Vincent, LLC | Clinic/Center | 9135 Sw Barnes Rd Ste 161, Portland, OR 97225 | 2018-03-07 |
| 1730606716 | Meghan Louise Lacy | Pediatrics | 11790 Sw Barnes Rd, Blg. A, Suite 140, Portland, OR 97225 | 2017-08-29 |
| 1841733433 | Tia Pugh | Occupational Therapist | 9155 S.w. Barnes Road, East Pavilion, Portland, OR 97225 | 2016-11-30 |
| 1295185585 | Stephanie Lynn Hart | Nurse Practitioner | 9155 Sw Barnes Rd Ste 240, Portland, OR 97225 | 2016-06-16 |
| 1962866244 | Bejian Shamloo | Chiropractor | 10200 Sw Eastridge St., Suite 235, Portland, OR 97225 | 2016-04-12 |
| 1992162630 | Robert Joseph Yoder | Psychologist | 9045 Barnes Rd, Portland, OR 97225 | 2016-01-26 |
| 1316303951 | Katie Herold | Chiropractor | 9315 Sw Morrison St, Portland, OR 97225 | 2016-01-12 |
| Find all providers in zip 97225 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598252272 | Venel Orthopaedic Institute At Lake Andrew | Orthopaedic Surgery | 10000 Se Main St Ste 205, Portland, OR 97216-2448 | 2018-04-18 |
| 1710382296 | Michael Baskin Md LLC | Orthopaedic Surgery | 4166 Sw Greenleaf Dr, Portland, OR 97221-3225 | 2014-10-27 |
| 1801132667 | Robert Andrew Berselli | Orthopaedic Surgery | 02113 Sw Military Rd, Portland, OR 97219-8428 | 2012-12-26 |
| 1134482284 | Andrew J Bryan | Orthopaedic Surgery | 1515 Nw 18th Ave Ste 300, Portland, OR 97209-2539 | 2012-06-22 |
| 1114297553 | Marc El Najjar | Orthopaedic Surgery | 1220 Sw 66th Ave # Appt2213, Portland, OR 97225-6022 | 2012-01-02 |
| 1245556984 | Penelope D Lang | Orthopaedic Surgery | 3500 N Interstate Ave, Kaiser Permanente, Interstate Medical Office South Orthopaedics, Portland, OR 97227-1196 | 2010-04-19 |
| 1154646453 | Ivanhoe B. Higgins, M.d., P.C. | Orthopaedic Surgery | 5050 Ne Hoyt St Ste 640, Portland, OR 97213-2990 | 2010-03-30 |
| 1811134836 | Robert Graf Mckillop | Orthopaedic Surgery | 21 Ne 7th Ave, Portland, OR 97232-2907 | 2009-01-13 |
| 1790920841 | Joseph Paul Schenck | Orthopaedic Surgery | 9925 Sw Quail Post Road, Portland, OR 97219 | 2008-12-03 |
| 1962680553 | Anthony Woodward | Orthopaedic Surgery | 10737 Sw Lancaster Rd, Portland, OR 97219-6494 | 2008-02-06 |
| 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.