SOUTH PORTLAND SURGICAL CENTER LLC (NPI# 1841507266) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841507266 |
| Entity Type | Organization |
| Organization Name | SOUTH PORTLAND SURGICAL CENTER LLC |
| Other Organization Name | SOUTH PORTLAND SURGICAL CENTER |
| Practice Address |
6370 Sw Borland Rd Suite 100 Tualatin OR 97062-9754 |
| Mailing Address |
1a Burton Hills Blvd Attn: L&c Nashville TN 37215-6187 |
| Practice Telephone | 5032181105 |
| Mailing Telephone | 6152403820 |
| Mailing Fax Number | 6152341720 |
| Enumeration Date | 2010-09-07 |
| Last Update Date | 2015-12-15 |
| Authorized Official Name | CLINT C CROMWELL (VICE PRESIDENT) |
| Authorized Official Telephone | 6152403820 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| South Portland Surgical Center | Doing Business As Name - Organization |
| Street Address |
6370 SW BORLAND RD SUITE 100 |
| City | TUALATIN |
| State | OR |
| Zip Code | 97062-9754 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215193057 | Keleigh Marie Nersasian | Physician Assistant | 6370 Sw Borland Rd, Suite 200, Tualatin, OR 97062-9768 | 2008-07-31 |
| 1366710782 | Dk Pathology | Clinical Medical Laboratory | 6370 Sw Borland Rd, Suite 206, Tualatin, OR 97062-9768 | 2011-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467018739 | Activeedge Tualatin, LLP | Physical Therapist | 19150 Sw 90th Avenue, Suite 200, West Linn, OR 97062 | 2019-05-13 |
| 1932607934 | Naturalways Pediatrics | Clinic/Center | 18813 Sw Martiazzi Ave, Tualatin, OR 97062 | 2018-01-25 |
| 1831646280 | Elizabeth Erin Tafesse | Behavioral Analyst | 18765 Sw Boones Ferry Rd Suite 100, Tualatin, OR 97062 | 2016-09-01 |
| 1962851311 | Ana Mercedes Cerritos-sanchez | Community Health Worker | 19355 Sw 65th Ave Apt A5, Tualatin, OR 97062 | 2016-06-07 |
| 1952759318 | William Luke Summers | Counselor | 18840 Southwest Boones Ferry Rd, Suite 208, Tualatin, OR 97062 | 2016-05-26 |
| 1730536913 | Krystle Alligood | Behavioral Analyst | 18768 Sw Boones Ferry Road, Tualatin, OR 97062 | 2016-05-18 |
| 1760869739 | Oregon City Medical Nw, Inc | Clinic/Center | 6464 Sw Borland Road #d-4, Tualatin, OR 97062 | 2015-04-29 |
| 1396148904 | Tracy Filley | Clinical Nurse Specialist | 18840 Sw Boones Ferry Rd, Suite 208, Tualatin, OR 97062 | 2014-09-28 |
| 1043646474 | Michelle Lords | Registered Nurse | 7668 Sw Mohawk Street, Tualatin, OR 97062 | 2013-09-17 |
| 1871930750 | Sharon Ruth Frank | Social Worker | 7668 Sw Mohawk St., Aps Healthcare, Tualatin, OR 97062 | 2013-05-31 |
| Find all providers in zip 97062 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801891668 | Cascade Spine Center, LLC | Clinic/Center | 6464 Sw Borland Rd, Bldg A Ste A-3, Tualatin, OR 97062-8876 | 2005-06-17 |
| 1366638843 | Meridian Center for Surgical Excellence | Clinic/Center | 19801 Sw 72nd Ave, Suite 170, Tualatin, OR 97062-8351 | 2007-09-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457826125 | Central Oregon Surgical Institute, LLC | Clinic/Center | 1550 Ne 27th St Ste 110, Bend, OR 97701-7728 | 2018-10-09 |
| 1316449168 | Surgery Center At St. Vincent, LLC | Clinic/Center | 9135 Sw Barnes Rd Ste 161, Portland, OR 97225 | 2018-03-07 |
| 1962920751 | West End Surgical, LLC | Clinic/Center | 9405 Sw Nimbus Ave, Beaverton, OR 97008 | 2017-09-01 |
| 1588181275 | Chase Gardens Surgery Center LLC | Clinic/Center | 360 S Garden Way Ste 100, Eugene, OR 97401-8173 | 2017-08-24 |
| 1164946984 | Northwest Renal Clinic, Inc. | Clinic/Center | 9701 Sw Barnes Rd Ste 110, Portland, OR 97225-6774 | 2017-08-02 |
| 1679939318 | Crater Lake Surgery Center LLC | Clinic/Center | 833 Bennett Ave, Medford, OR 97504-6715 | 2016-01-11 |
| 1902287469 | Gateway Dental Surgery Center | Clinic/Center | 10535 Ne Glisan St Ste 101, Portland, OR 97220-4095 | 2015-06-10 |
| 1760861835 | Central Oregon Surgery Center LLC | Clinic/Center | 1835 Nw Pence Ln Ste 100, Bend, OR 97703-1551 | 2015-05-22 |
| 1972902286 | Oregon Specialists Surgery Center LLC | Clinic/Center | 2785 River Rd S, Salem, OR 97302-5883 | 2014-08-22 |
| 1649612698 | Willamette Procedure Center PC | Clinic/Center | 2020 8th Ave Ste 212, West Linn, OR 97068-4657 | 2013-07-18 |
| Find all providers with the same taxonomy | ||||
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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.