SOUTH TABOR FAMILY PHYSICIANS
NPI 1982649299
Clinic/Center in Portland, OR
NPI Status: Active since June 19, 2006
Contact Information
10803 SE CHERRY BLOSSOM DR
PORTLAND, OR
ZIP 97216
Phone: (503) 261-7200
Fax: (503) 261-7249
- Organization
- Clinic/Center
- Accepts Insurance
- CLIA Number: 38D0623570
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 10-09-2026
About SOUTH TABOR FAMILY PHYSICIANS
This page provides the complete NPI Profile along with additional information for South Tabor Family Physicians, a provider established in Portland, Oregon operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1982649299 assigned on June 2006. The practitioner's primary taxonomy code is 261Q00000X with license number 262417 (OR). The provider is registered as an organization and their NPI record was last updated 14 years ago. The authorized official of this NPI record is Londa Everett (Administrator)
- NPI
- 1982649299
- Provider Name
- SOUTH TABOR FAMILY PHYSICIANS
- Entity Type
- Organization
- Location Address
- 10803 SE CHERRY BLOSSOM DR PORTLAND, OR 97216
- Location Phone
- (503) 261-7200
- Location Fax
- (503) 261-7249
- Mailing Address
- 10803 SE CHERRY BLOSSOM DR PORTLAND, OR 97216
- Mailing Phone
- (503) 261-7200
- Mailing Fax
- (503) 261-7249
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-19-2006
- Last Update Date
- 10-03-2012
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center
- Taxonomy Code
- 261Q00000X
- Type
- Ambulatory Health Care Facilities
- License No.
- 262417
- License State
- OR
- Taxonomy Description
- A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BridgeSpan Standard Bronze Plan - EPO
- BridgeSpan Standard Gold Plan - EPO
- BridgeSpan Standard Silver Plan - EPO
- Moda Health Affinity Bronze 8000 - EPO
- Moda Health Affinity Bronze 9000 - EPO
- Moda Health Affinity Bronze HDHP 7500 - EPO
- Moda Health Affinity Gold 1000 - EPO
- Moda Health Affinity Gold 1500 - EPO
- Moda Health Affinity Gold 250 - EPO
- Moda Health Affinity Silver 3000 - EPO
- Moda Health Affinity Silver 3400 - EPO
- Moda Health Affinity Silver 4500 - EPO
- Moda Health Affinity Silver 6000 - EPO
- Connect 1500 Gold - EPO
- Connect 6000 Silver - EPO
- Connect 9800 Bronze - EPO
- HSA Qualified 7500 Bronze - Choice Network - EPO
- HSA-E Qualified 7500 Bronze - Signature Network - EPO
- Providence Oregon Standard Bronze Plan - Choice Network - EPO
- Providence Oregon Standard Bronze Plan - Signature Network - EPO
- Providence Oregon Standard Gold Plan - Choice Network - EPO
- Providence Oregon Standard Gold Plan - Signature Network - EPO
- Providence Oregon Standard Silver Plan - Choice Network - EPO
- Bronze 8000 Individual Connect - EPO
- Bronze Essential 9000 With 4 Copay No Deductible Office Visits Individual Connect - EPO
- Bronze Essential 9000 With 4 Copay No Deductible Office Visits Legacy - EPO
- Bronze HSA 7000 Individual Connect - EPO
- Gold 2300 Individual Connect - EPO
- Gold 2300 Legacy - EPO
- Regence Standard Bronze Plan Individual Connect - EPO
- Regence Standard Bronze Plan Legacy - EPO
- Regence Standard Gold Plan Individual Connect - EPO
- Regence Standard Gold Plan Legacy - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 00WCBBR | MEDICARE ID-TYPE UNSPECIFIED (04) | OR |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 38D0623570
- Facility Type
- Physician Office
- Certificate Effective Date
- October 10, 2024
- Certificate Expiration Date
- October 09, 2026
- Laboratory Director
- DR. WILLIAM B. BRONEC
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to South Tabor Family Physicians on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
Reviews for SOUTH TABOR FAMILY PHYSICIANS
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1982649299, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 71. The final step is to find the difference between that total and the next multiple of ten (80 - 71 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 71 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 18 providers are registered at the same or a nearby location.
PORTLAND, OR 97216
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1982649299, enumerated as an "organization" on June 19, 2006.
The provider is located at 10803 SE CHERRY BLOSSOM DR PORTLAND, OR 97216 and the phone number is (503) 261-7200.
Clinic/Center with taxonomy code 261Q00000X.
The provider might be accepting Accepts: BridgeSpan Health Company, Moda Health Plan, Inc.,. Please consult your insurance carrier or call the provider to verify.
