DR. SAMUDYATHA SHIVALINGAPPA (NPI# 1841286960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841286960 |
| Entity Type | Individual |
| Full Name | DR. SAMUDYATHA SHIVALINGAPPA |
| Credential | M.D. |
| Practice Address |
15700 Sw Greystone Ct Beaverton OR 97006-6011 |
| Mailing Address |
1200 Nw 23rd Ave Portland OR 97210-2906 |
| Practice Telephone | 9712629150 |
| Practice Fax Number | 9712629151 |
| Mailing Telephone | 5034137074 |
| Mailing Fax Number | 5034136769 |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2020-10-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | MD23979 | OR | Allopathic & Osteopathic Physicians |
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
MD23979 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 117023 | 05 |
| Street Address |
15700 SW GREYSTONE CT |
| City | BEAVERTON |
| State | OR |
| Zip Code | 97006-6011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730718768 | Marvin C Smith | Physical Therapist | 15700 Sw Greystone Ct, Beaverton, OR 97006-6011 | 2020-04-02 |
| 1982185344 | Anna-lise K Krippaehne | Registered Nurse | 15700 Sw Greystone Ct, Beaverton, OR 97006-6011 | 2018-08-23 |
| 1912441213 | Catherine Weeks | Social Worker | 15700 Sw Greystone Ct, Beaverton, OR 97006-6011 | 2016-12-06 |
| 1588059885 | Yuka Kobayashi | Family Medicine | 15700 Sw Greystone Ct, Beaverton, OR 97006-6011 | 2015-04-02 |
| 1649695990 | Nicole Hornberger | Counselor | 15700 Sw Greystone Ct, Beaverton, OR 97006 | 2014-02-24 |
| 1295172419 | Ryan M. Norton | Family Medicine | 15700 Sw Greystone Ct, Beaverton, OR 97006-6011 | 2013-05-29 |
| 1407191042 | Sarah Lowry | Nurse Practitioner | 15700 Sw Greystone Ct, Beaverton, OR 97006-6011 | 2012-12-09 |
| 1679716716 | Craig Samuel Mcdougall | Internal Medicine | 15700 Sw Greystone Ct, Beaverton, OR 97006-6011 | 2009-04-18 |
| 1114164381 | Oregon Health & Science University | Pharmacy | 15700 Sw Greystone Ct, Beaverton, OR 97006-6011 | 2009-01-09 |
| 1184884470 | Katharine Louise Barford | Internal Medicine | 15700 Sw Greystone Ct, Oregon Health Sciences University, Beaverton, OR 97006-6011 | 2008-06-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184238727 | Hayden Alexander Meriwether | Dentist | 17895 Ne Evergreen Pkwy, #100, Beaverton, OR 97006 | 2020-09-01 |
| 1336781202 | Courtney Rae Murata | Behavior Technician | 337 Nw 215th Terrace, Apt, 106, Hillsboro, OR 97006 | 2019-10-11 |
| 1992355986 | Pamela J. Viado | Technician | 1220 Nw Weybridge Way, Beaverton, OR 97006 | 2019-09-12 |
| 1477115384 | One Change Group | Community/Behavioral Health | 2499 Nw 206th Ave, Apt A233, Hillsboro, OR 97006 | 2019-07-01 |
| 1649731332 | Regina C. Rizo | Social Worker | 1925 Amberglen Parkway, #3a-131, Hillsboro, OR 97006 | 2019-03-26 |
| 1043731912 | Elizabeth A Cintron | Occupational Therapy Assistant | 1189 Ne 89th Ave Apt 305, Hillsboro, OR 97006 | 2017-06-30 |
| 1265979173 | Lindsay Jensen | Massage Therapist | 15220 Nw Greenbrier Pkwy Ste 260, Beaverton, OR 97006 | 2017-01-30 |
| 1851835722 | Changepoint, Inc | Clinic/Center | 1700 Nw 167th Place, Suite 240, Beaverton, OR 97006 | 2016-12-13 |
| 1689126302 | Occupational Health Centers of The Southwest, P.a. (tx) | Clinic/Center | 2225 Nw Towncenter Drive, Beaverton, OR 97006 | 2016-10-28 |
| 1558717413 | Dillon Duvall | Physical Therapist | 16895 Nw Cornell Rd, #110, Beaverton, OR 97006 | 2016-05-10 |
| Find all providers in zip 97006 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326450651 | Neha Rupal Naik | Internal Medicine | 2925 River Road South, Suite 110, Salem, OR 97302 | 2014-05-21 |
| 1346526548 | Geriatric and Nursing Home | Internal Medicine | 441 Silverado Cir, Medford, OR 97504-8167 | 2011-11-01 |
| 1831353226 | Sonal Sonia Thakur | Internal Medicine | 19565 Aster Ln, Bend, OR 97702-2111 | 2008-07-15 |
| 1093916470 | Kellie Rooney Foster | Internal Medicine | 2710 Nw Vaughn St, Suite 160, Portland, OR 97210-5344 | 2007-05-31 |
| 1447310859 | Karen Kruse | Internal Medicine | 8200 Se Barbara Welch Rd, Portland, OR 97236-5335 | 2006-12-08 |
| 1083729214 | Stephen Arnold Ebert | Internal Medicine | 2701 Nw Vaughn St., Suite 160, Portland, OR 97201 | 2006-08-20 |
| 1326152935 | Frances May Yuhas | Internal Medicine | 818 W 6th St Ste 4, The Dalles, OR 97058-1147 | 2006-08-19 |
| 1609892736 | Paul Gowen | Internal Medicine | 3635 Ne Alameda St, Portland, OR 97212-1812 | 2006-07-14 |
| 1669418810 | Douglas Reed Grossnickle | Internal Medicine | 10373 Ne Hancock, Suite 219, Portland, OR 97220 | 2006-06-22 |
| 1821030552 | Steven Delashmutt | Internal Medicine | 3640 H St, Baker City, OR 97814-1278 | 2006-06-10 |
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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.