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NEPHROLOGY MEDICAL ASSOCIATES OF GEORGIA LLC NPI 1588690887


NPI Information

NPI: 1588690887
Provider Name: NEPHROLOGY MEDICAL ASSOCIATES OF GEORGIA, LLC

Doing Business As: OREGON KIDNEY AND HYPERTENSION CLINIC

Classification: Internal Medicine - 207RN0300X
Entity Type: Organization

Specialization: Nephrology

Address:
15895 SW 72ND AVE STE 250
BLDG B
TIGARD, OR
ZIP 97224
Phone: (503) 624-5630
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NEPHROLOGY MEDICAL ASSOCIATES OF GEORGIA, LLC is a nephrology internal medicine in Tigard, OR. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. NEPHROLOGY MEDICAL ASSOCIATES OF GEORGIA, LLC NPI is 1588690887. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Oregon Kidney And Hypertension Clinic.

The provider's business location address is:

15895 SW 72ND AVE STE 250
BLDG B
TIGARD, OR
ZIP 97224-966
Phone: (503) 624-5630
Fax: (503) 624-9149

The provider's authorized official is Deron Frank .
The authorized official title is General Manager, Vice President and has the following contact phone number (310) 536-2402.

The enumeration date for this NPI number is 6/25/2006 and was last updated on 9/13/2012.


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
1207RN0300XInternal MedicineNephrologyYes

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 Other Provider Identifier Issuer
1OMAP006021MEDICAIDOREGON
2R134795MEDICARE PINOREGON

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: 5/5/2024

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