DR. KEITH PHILLIP CROSS M.D. NPI 1528105194

NPI Information

NPI: 1528105194
Provider Name: DR. KEITH PHILLIP CROSS, M.D.
Classification: Emergency Medicine - 207PP0204X
Entity Type: Individual

Specialization: Pediatric Emergency Medicine

PECOS Registration: Yes

Address:
3181 SW SAM JACKSON PARK RD
PORTLAND, OR
ZIP 97239
Phone: (503) 494-7551
Get Directions

DR. Keith Phillip Cross, M.D. is a pediatric emergency medicine emergency medicine in Portland, OR. The provider is pediatric Emergency Medicine is a clinical subspecialty that focuses on the care of the acutely ill or injured child in the setting of an emergency department. DR. Keith Phillip Cross, M.D. NPI is 1528105194. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3181 SW SAM JACKSON PARK RD
PORTLAND, OR
ZIP 97239-011
Phone: (503) 494-7551
Fax: (503) 494-4997

The NPI 1528105194 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/31/2007 and was last updated on 3/15/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208000000X	Pediatrics		294757-1	NEW YORK	No
2	208000000X	Pediatrics		MD214291	OREGON	No
3	2080P0204X	Pediatrics	Pediatric Emergency Medicine	40990	KENTUCKY	No
4	2080P0204X	Pediatrics	Pediatric Emergency Medicine	294757-1	NEW YORK	No
5	207PP0204X	Emergency Medicine	Pediatric Emergency Medicine	MD214291	OREGON	Yes
6	207R00000X	Internal Medicine		MD214291	OREGON	No
7	208000000X	Pediatrics		40990	KENTUCKY	No
8	207R00000X	Internal Medicine		40990	KENTUCKY	No
9	207R00000X	Internal Medicine		294757-1	NEW YORK	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	200882960	MEDICAID	INDIANA
2	7100025500	MEDICAID	KENTUCKY
3	03822786	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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