ASCENSION MEDICAL GROUP LLC (NPI# 1558719450) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558719450 |
| Entity Type | Organization |
| Organization Name | ASCENSION MEDICAL GROUP LLC |
| Practice Address |
700 N Hayden Island Dr Ste 100 Portland OR 97217-8130 |
| Practice Telephone | 9715335840 |
| Practice Fax Number | 9712702806 |
| Mailing Telephone | 9715335840 |
| Mailing Fax Number | 9712702806 |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2016-06-01 |
| Authorized Official Name | DR. JOHN HENRY HARDY JR. (MANAGING MEMBER-MEDICAL DIRECTOR) |
| Authorized Official Telephone | 9718041906 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | ASCENSION MEDICAL GROUP LLC | 700 N Hayden Island Dr Ste 100, Portland, OR 97217 |
| Street Address |
700 N HAYDEN ISLAND DR STE 100 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97217-8130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831144872 | Sounak N Misra | Internal Medicine | 700 N Hayden Island Dr Ste 100, Portland, OR 97217-8130 | 2006-05-24 |
| 1942522388 | John Henry Hardy Jr. | Family Medicine | 700 N Hayden Island Dr Ste 100, Portland, OR 97217-8130 | 2010-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326531666 | Working Class Medicine LLC | Clinic/Center | 2133 N. Willis Blvd, Studio D, Portland, OR 97217 | 2018-06-12 |
| 1235643602 | Autism Outreach of Oregon | Occupational Therapist | 10350 N Vancouver Way #1043, Portland, OR 97217 | 2017-11-21 |
| 1689183717 | Kai-uwe H. Hahn Dmd Dba Edelweiss Dental | Clinic/Center | 3503 N Lombard Street, Portland, OR 97217 | 2017-09-20 |
| 1407308125 | Occupational Health Centers of The Southwest, P.a. (tx) | Clinic/Center | 3449 N Anchor Street, Ste 300a, Portland, OR 97217 | 2016-10-28 |
| 1750740577 | Sheila Amoo | Adult Companion | 236 N Killingworth St. Apt.b104, Portland, OR 97217 | 2016-02-22 |
| 1801282199 | Justine Osborn | Specialist | 4310 N. Interstate Ave, Portland, OR 97217 | 2015-04-13 |
| 1578957742 | Paul Buck Md, Dds, PC | Clinic/Center | 3332 N Lombard St, Suite C, Portland, OR 97217 | 2015-03-25 |
| 1295158186 | Rebecca Bulleri | Massage Therapist | 5416 N. Maryland Ave, Portland, OR 97217 | 2014-01-28 |
| 1659793107 | Shellmire Unlimited, P.C. | Community/Behavioral Health | 4134 N Vancouver Avenue, Suite 102, Portland, OR 97217 | 2014-01-16 |
| 1417207994 | Sportland Acupuncture LLC | Acupuncturist | 1025 N Humboldt, Portland, OR 97217 | 2012-09-12 |
| Find all providers in zip 97217 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649838590 | Boulder Care Provider Group Pa | Family Medicine | 208 Sw Harvey Milk St Ste 200, Portland, OR 97204-2611 | 2019-06-04 |
| 1417333535 | Ascension Health Centers | Family Medicine | 8083 Se 13th Ave, Suite #3, Portland, OR 97202-6668 | 2015-07-31 |
| 1316006166 | Stephen Cameron | Family Medicine | 3449 N Anchor St, Suite 300a, Portland, OR 97217-7679 | 2006-12-07 |
| 1619538782 | Gabrielle Alyson Bowker | Family Medicine | 17 Bishop St, Portland, ME 04103-2659 | 2019-06-27 |
| 1073978284 | Robbie Bahl, Md LLC | Family Medicine | 3769 Se Milwaukie Ave, Portland, OR 97202-3804 | 2015-12-15 |
| 1144648312 | Bradley Michael Buchheit | Family Medicine | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2014-04-03 |
| 1013273861 | Andrea Gough-goldman | Family Medicine | 1030 Ne Couch St, Portland, OR 97232-3067 | 2012-04-05 |
| 1942522388 | John Henry Hardy Jr. | Family Medicine | 700 N Hayden Island Dr Ste 100, Portland, OR 97217-8130 | 2010-02-26 |
| 1942469762 | Robbie Bahl | Family Medicine | 3769 Se Milwaukie Ave, Portland, OR 97202-3804 | 2008-06-06 |
| 1033232996 | Jeffrey Benton Hayes | Family Medicine | 1027 E Burnside St, Portland, OR 97214-1328 | 2007-04-07 |
| 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.