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Active NPI 1891742318 Organization (Entity Type 2)

Gresham Podiatry Center, Llc

Podiatrist - Foot & Ankle Surgery • Gresham, OR

About Gresham Podiatry Center, Llc NPI 1891742318 Summary

Gresham Podiatry Center, Llc is a verified healthcare organization specializing in Podiatrist - Foot & Ankle Surgery operating in Gresham, OR. Located at 831 NW COUNCIL DR, SUITE #203, this facility provides patient care and medical services under National Provider Identifier (NPI) 1891742318.

Administrative operations and authorized compliance are overseen by Derek Mccammon (Owner).

The facility is associated with 13 linked healthcare practitioners providing clinical services.

Facility Location & Contact Primary Location

Facility Address

831 Nw Council Dr
Suite #203

Gresham, OR 970303721

Telephone 5036676600
Fax 5036676608

Authorized Official Information

Authorized Contact Name

DR. Derek Mccammon , D.P.M.

Title / Role

Owner

Official Telephone

5036676600

Facility Classifications & Specialties

Podiatrist - Foot & Ankle Surgery Primary Taxonomy

NUCC Taxonomy Code: 213ES0103X

Definition to come...

Affiliated Practitioners & Clinicians

Healthcare professionals and specialists practicing at this facility or affiliated group locations

13 Linked

Family Medicine

Gresham, OR

View Practitioner Profile →

Family Medicine

Gresham, OR

View Practitioner Profile →
Maria Kling , NP NPI 1386897809

Nurse Practitioner - Adult Health

Gresham, OR

View Practitioner Profile →

Nurse Practitioner - Family

Gresham, OR

View Practitioner Profile →
Dr. Craig Davis , MD NPI 1508975715

Internal Medicine

Gresham, OR

View Practitioner Profile →

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

6 Historical Events
NPI Profile Active April 02, 2008

NPI status registered as active in NPPES database

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Updated Practice Location April 02, 2008

Registered at 831 NW COUNCIL DR, SUITE #203, GRESHAM, OR 970303721 (Tel: 5036676600)

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Updated Business Mailing Address April 02, 2008

Registered at 831 NW COUNCIL DR, SUITE #203, GRESHAM, OR 970303721 (Tel: 5036676600)

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Organization / Clinic Name Updated April 02, 2008

Operating as GRESHAM PODIATRY CENTER, LLC

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Medical Taxonomy / Specialty Registered (Primary Specialty) April 02, 2008

Podiatrist (License #307 in OR)

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Initial NPI Registration & Enumeration May 28, 2006

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

Verified patient ratings, healthcare experiences, and facility photos

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NPI Organization Metadata

NPI Number: 1891742318
Entity Type:
Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)
Enumeration Date: May 28, 2006
Last Update: April 02, 2008

Mailing Address

831 Nw Council Dr, Suite #203

Gresham, OR 970303721

Phone: 5036676600

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.
⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.