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RANDELL PETER JURA M.D.
NPI 1104272921
Family Medicine - Adult Medicine in Portland, OR

Active since May 11, 2016
10915 SE STARK ST, PORTLAND, OR 97216(503) 261-1120(503) 261-8936 Get Directions Write a Review

NPPES record last updated: July 21, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 21, 2023, May 11, 2016 (2 updates tracked since 2016).

About Randell Peter Jura M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RANDELL PETER JURA M.D. (NPI 1104272921) is an individual adult medicine provider in Portland, Oregon, licensed in Oregon (12431) and active in the NPI registry since May 2016.

NPPES Registry Identity

NPI1104272921
Entity TypeIndividualMale
Primary Taxonomy207QA0505X
Provider Legal NameRANDELL PETER JURACredential: M.D.
Location Address10915 SE STARK STPortland, OR 97216-3348
Mailing Address10915 Se Stark StPortland, OR 97216-3348 · (503) 261-1120 · Fax (503) 261-8936
Phone(503) 261-1120
Fax(503) 261-8936
Sole ProprietorYes
Enumeration DateMay 11, 2016
Last NPPES UpdateJuly 21, 20232 updates tracked since enumeration
NPPES CertifiedJuly 21, 2023
✔ NPI 1104272921 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Adult MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0505X
License✔ Licensed in OR · 12431
Definition
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.
10915 SE STARK ST, Portland, OR 97216
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Other Identifiers 2

Medicaid26053-9OR
Other0000BHPBDOR · Oregon Workers Comp

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WHALEN ACUPUNCTURE AND WELLNESS, LLC
Acupuncturist
10915 SE STARK ST
PORTLAND, OR 97216
Multnomah County (503) 261-1120
DR. BREE-LYN MARTINDALE DPT
Physical Therapist
10915 SE STARK ST
PORTLAND, OR 97216
Multnomah County (503) 261-1120
JIMENA LUJAN SERRANO OLDHAM PT
Physical Therapist
10915 SE STARK ST
PORTLAND, OR 97216
Multnomah County (503) 261-1120
DR. ANDREW CONNER DPT
Physical Therapist
10915 SE STARK ST
PORTLAND, OR 97216
Multnomah County (503) 261-1120
CASSANDRA LA MADRID
Physical Therapy Assistant
10915 SE STARK ST
PORTLAND, OR 97216
Multnomah County (503) 261-1120
MR. SY LABTHAVIKUL PTA
Physical Therapy Assistant
10915 SE STARK ST
PORTLAND, OR 97216
Multnomah County (503) 261-1120
MR. STANLEY ROBERT GORMAN P.T.
Physical Therapist
10915 SE STARK ST
PORTLAND, OR 97216
Multnomah County (503) 261-1120
WANDA ELIZABETH NORMAN LMT, LAC
Acupuncturist
10915 SE STARK ST
PORTLAND, OR 97216
Multnomah County (503) 261-1120

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Randell Jura's NPI number?

The NPI number for Randell Jura is 1104272921. It was assigned to this individual provider in the NPPES registry on May 11, 2016.

Where is Randell Jura located?

Randell Jura practices at 10915 SE Stark St, Portland, OR 97216. The listed phone number is (503) 261-1120.

What is Randell Jura's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

When was this NPI record last updated?

The NPPES record for Randell Jura was last updated on July 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.