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FAMILY MEDICAL GROUP NORTHEAST, P.C.
NPI 1831385673
Family Medicine in Portland, OR

Active since September 14, 2007CLIA 38D0623880 · Waiver
2647 NE 33RD AVE, PORTLAND, OR 97212(503) 288-0083(503) 288-7843 Get Directions Write a Review

NPPES record last updated: September 14, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Family Medical Group Northeast, P.c. NPPES

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

FAMILY MEDICAL GROUP NORTHEAST, P.C. (NPI 1831385673) is a healthcare organization registered as a family medicine in Portland, Oregon and active in the NPI registry since September 2007. The organization holds a CLIA Waiver certificate valid through February 13, 2027 and lists Keirene Adams, Administrator, as its authorized official.

NPPES Registry Identity

NPI1831385673
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameFAMILY MEDICAL GROUP NORTHEAST, P.C.
Location Address2647 NE 33RD AVEPortland, OR 97212-3647
Mailing Address2647 Ne 33rd AvePortland, OR 97212-3647 · (503) 288-0083 · Fax (503) 288-7843
Phone(503) 288-0083
Fax(503) 288-7843
Organization SubpartNo
Authorized OfficialKeirene AdamsAdministrator · (503) 288-0083
Enumeration DateSeptember 14, 2007
✔ NPI 1831385673 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
2647 NE 33RD AVE, Portland, OR 97212
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Other Identifiers 1

OtherR000WCHMDOR · Medicare Group Number

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 38D0623880

Family Medical Group, NE · Portland, OR
Active · expires Feb 13, 2027
CLIA Number38D0623880
Laboratory TypePhysician Office
Certificate Effective DateFebruary 14, 2025
Certificate Expiration DateFebruary 13, 2027
Laboratory DirectorDeona L. Bridgeman
Laboratory Phone(503) 288-0083
Laboratory LocationFamily Medical Group, NE2647 NE 33rd Ave, Portland, OR 97212
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

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

MS. SUSAN MARIE VOCKERT-BURKE FNP
Nurse Practitioner (Family)
2647 NE 33RD AVE
PORTLAND, OR 97212
Multnomah County (503) 288-0083
TEURA KEENO
Physician Assistant
2647 NE 33RD AVE
PORTLAND, OR 97212
Multnomah County (503) 288-0083
THOMAS P HARVEY MD
Family Medicine
2647 NE 33RD AVE
PORTLAND, OR 97212
Multnomah County (503) 288-0083
DR. ANNE NGUYEN SKINNER DO
Family Medicine
2647 NE 33RD AVE
PORTLAND, OR 97212
Multnomah County (503) 288-0083
MICHAEL BOOKER MD
Family Medicine
2647 NE 33RD AVE
PORTLAND, OR 97212
Multnomah County (503) 288-0083
OREGON HEALTHCARE RESOURCES LLC
Durable Medical Equipment & Medical Supplies
2647 NE 33RD AVE
PORTLAND, OR 97212
Multnomah County (503) 288-0083
SHARLEEN PAYNICH CARRAWAY APRN, BC
Nurse Practitioner (Family)
2647 NE 33RD AVE
PORTLAND, OR 97212
Multnomah County (503) 288-0083

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 Family Medical Group Northeast, P.C.'s NPI number?

The NPI number for Family Medical Group Northeast, P.C. is 1831385673. It was assigned to this organization in the NPPES registry on September 14, 2007.

Where is Family Medical Group Northeast, P.C. located?

Family Medical Group Northeast, P.C. is located at 2647 NE 33rd Ave, Portland, OR 97212. The listed phone number is (503) 288-0083.

What is Family Medical Group Northeast, P.C.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Family Medical Group Northeast, P.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 38D0623880) is associated with this NPI, valid through February 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Family Medical Group Northeast, P.C. accept?

Health plans from Providence Health Plan list Family Medical Group Northeast, P.C. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Family Medical Group Northeast, P.C. was last updated on September 14, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.