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  7. NPI Record 1275559940

EDWARD CHAPLAIN MD
Complete NPI Record 1275559940
Family Medicine in Portland, OR


Quality Rating: 86.45 out of 100 score

NPI Status: Active since July 14, 2006

Contact Information

839 NE HOLLADAY ST
PORTLAND, OR
ZIP 97232
Phone: (503) 203-0700

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Credential Text
  6. Provider First Line Business Mailing Address
  7. Provider Business Mailing Address City Name
  8. Provider Business Mailing Address State Name
  9. Provider Business Mailing Address Postal Code
  10. Provider Business Mailing Address Country Code If outside U S
  11. Provider Business Mailing Address Telephone Number
  12. Provider Business Mailing Address Fax Number
  13. Provider First Line Business Practice Location Address
  14. Provider Business Practice Location Address City Name
  15. Provider Business Practice Location Address State Name
  16. Provider Business Practice Location Address Postal Code
  17. Provider Business Practice Location Address Country Code If outside U S
  18. Provider Business Practice Location Address Telephone Number
  19. Provider Enumeration Date
  20. Last Update Date
  21. Provider Gender Code
  22. Healthcare Provider Taxonomy Code 1
  23. Provider License Number 1
  24. Provider License Number State Code 1
  25. Healthcare Provider Primary Taxonomy Switch 1
  26. Healthcare Provider Taxonomy Code 2
  27. Provider License Number 2
  28. Provider License Number State Code 2
  29. Healthcare Provider Primary Taxonomy Switch 2
  30. Other Provider Identifier 1
  31. Other Provider Identifier Type Code 1
  32. Other Provider Identifier State 1
  33. Other Provider Identifier 2
  34. Other Provider Identifier Type Code 2
  35. Other Provider Identifier State 2
  36. Other Provider Identifier Issuer 2
  37. Is Sole Proprietor
  38. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1275559940. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1275559940
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Entity Type Code: 1
The city name in the mailing address of the provider being identified.
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: EDWARD
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider Credential Text: MD
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Provider First Line Business Mailing Address: PO BOX 3158
Provider Business Mailing Address City Name: PORTLAND
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Provider Business Mailing Address State Name: OR
Provider Business Mailing Address Postal Code: 972083158
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Provider Business Mailing Address Country Code If outside U S : US
Provider Business Mailing Address Telephone Number: 5032156494
The city name in the location address of the provider being identified.
Provider Business Mailing Address Fax Number: 5032156644
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider First Line Business Practice Location Address: 839 NE HOLLADAY ST
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address City Name: PORTLAND
The date that a record was last updated or changed.
Provider Business Practice Location Address State Name: OR
The first name of the authorized official.
Provider Business Practice Location Address Postal Code: 972323521
The 10-position telephone number of the authorized official.
Provider Business Practice Location Address Country Code If outside U S : US
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider Business Practice Location Address Telephone Number: 5032030700
Provider Enumeration Date: 7/14/2006
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Last Update Date: 10/19/2020
Provider Gender Code: M
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 207Q00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: MD25602
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: OR
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: Y
Healthcare Provider Taxonomy Code 2: 207Q00000X
Provider License Number 2: MD00045134
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 2: WA
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 2: N
Other Provider Identifier 1: 500618677
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 1: 05
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1: OR
Other Provider Identifier 2: P01064947
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 2: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 2: OR
Other Provider Identifier Issuer 2: RR MEDICARE - PH&S - OREGON (PMG)
The date that a record was last updated or changed.
Is Sole Proprietor: N
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
NPI Certification Date: 10/19/2020