GENESIS MEDICAL GROUP, LLC.


Address: 16679 Boones Ferry Rd Ste 215, Lake Oswego, OR 97035-4368
Phone: 5036991911

GENESIS MEDICAL GROUP, LLC. (NPI# 1457517138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1457517138
Entity Type Organization
Organization Name GENESIS MEDICAL GROUP, LLC.
Practice Address 16679 Boones Ferry Rd Ste 215
Lake Oswego
OR 97035-4368
Practice Telephone 5036991911
Practice Fax Number 5036991912
Mailing Telephone 5036991911
Mailing Fax Number 5036991912
Enumeration Date 2008-08-01
Last Update Date 2012-04-03
Authorized Official Name MR. WYATT JAMES BROWN (DIRECTOR OF OPERATION)
Authorized Official Telephone 5036991911
Authorized Official Credential CPED
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 335E00000X Prosthetic/Orthotic Supplier 1355445-0 OR Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
OR BLUE CROSS BLUE SHIELD 081911000 01
OR 500608071 05

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1326290248 Genesis Medical Group, LLC. Prosthetic/Orthotic Supplier 1338 Commerce Ave Ste D, Longview, WA 98632-3743 2008-10-22
1740538115 Genesis Medical Group, LLC. Prosthetic/Orthotic Supplier 1515 Nw 18th Ave, Suite 100, Portland, OR 97209-2516 2012-08-16

Other Data Sources

Entity Type Entity Name Entity Address
Washington State Corporations GENESIS MEDICAL GROUP, LLC 10910 Domain Dr, Ste 300, Austin, TX 78758-7807

Office Location

Street Address 16679 BOONES FERRY RD STE 215
City LAKE OSWEGO
State OR
Zip Code 97035-4368

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1932700127 Teresa Siebenaler Scott Social Worker 3990 Sw Collins Way, Suite 202, Lake Owsego, OR 97035 2020-11-04
1528671567 Martin Henry Lees Internal Medicine 14 Morningview Lane, Lake Oswego, OR 97035 2020-08-28
1356976187 Premere Rehab LLC Occupational Therapist Infinity Rehab - The Springs At Lake Oswego, 3900 Kruse Way Pl, Lake Oswego, OR 97035 2020-03-12
1689212193 Jennifer Chauvin Nurse Practitioner 20 Juarez Street, Lake Oswego, OR 97035 2019-12-16
1003396888 Sarah Guenzburger Physical Therapist 3900 Kruse Way Pl, Lake Oswego, OR 97035 2018-08-21
1568964252 Brett Johnson Marriage & Family Therapist 5655 Southwood Dr, Lake Oswego, OR 97035 2018-03-08
1912416561 Michael Paul Long Social Worker 14523 Westlake Drive, Lake Oswego, Or 97035, Lake Oswego, OR 97035 2017-09-27
1467807859 Misty Lohn Nurse Practitioner 5 Centerpointe Dr., Ste 600, Lake Oswego, OR 97035 2016-05-04
1326405473 Kelsey Prince Behavioral Analyst 6400 Sw Rosewood St., Portland (lake Oswego), OR 97035 2016-01-20
1942683388 Elizabeth Risberg Harrison Massage Therapist 190 Oswego Summit, Lake Oswego, OR 97035 2015-07-02
Find all providers in zip 97035

Taxonomy Information

Taxonomy Code 335E00000X
Grouping Suppliers
Classification Prosthetic/Orthotic Supplier

Taxonomy Definition

An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1992721294 Pro-tech Sports Medicine, Inc. Prosthetic/Orthotic Supplier 16679 Boones Ferry Rd, Suite 215, Lake Oswego, OR 97035-4365 2006-07-14

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1811500705 Synergy Medical Systems, LLC Prosthetic/Orthotic Supplier 19365 Sw 65th Ave Ste 210, Tualatin, OR 97062-9196 2020-08-28
1881007607 Shannon Levin Prosthetic/Orthotic Supplier 441 Union St Ne, Salem, OR 97301-2458 2014-06-09
1174892640 Cognitive Harmonics, Inc Prosthetic/Orthotic Supplier 2104 Hill Way, Medford, OR 97504-6208 2011-12-29
1841581717 Pacific Footwear Company Inc Prosthetic/Orthotic Supplier 1150 Knutson Ave, Suite 12, Medford, OR 97504-3100 2011-04-27
1417257742 A Step Forward LLC Prosthetic/Orthotic Supplier 744 Hawthorne Ave Ne, Salem, OR 97301-4675 2010-11-03
1467783761 Elliott Pedorthic Care LLC Prosthetic/Orthotic Supplier 85084 Kensington Dr, Pleasant Hill, OR 97455-9621 2010-01-26
1780836049 Angel Hair Foundation Inc Prosthetic/Orthotic Supplier 2783 Suncrest Ave, Eugene, OR 97405-5923 2008-10-17
1295986065 Mirage Hair Systems, Inc. Prosthetic/Orthotic Supplier Suite 210 Oakway Ctr, Suite 210, Eugene, OR 97401-5618 2008-10-09
1518148105 Paradox Walkfit Inc. Prosthetic/Orthotic Supplier 15532 Sw Pacific Hwy, Suite C1a, Tigard, OR 97224-3598 2007-11-24
1821286501 Willamette Orthotics & Prosthetics LLC Prosthetic/Orthotic Supplier 333 Nw Larch Ave Ste 1, Redmond, OR 97756-1359 2007-10-09
Find all providers with the same taxonomy

Competitor

Search similar providers

City LAKE OSWEGO
Zip Code 97035

Improve Information

Please comment or provide details below to improve the information on GENESIS MEDICAL GROUP, LLC..

Dataset Information

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.

Trending Searches