Mr. Charles L Darby
Internal Medicine

Address: 4212 Ne Broadway St, Portland, OR 97213-1460
Phone: 5032498787

Mr. Charles L Darby (NPI# 1942376850) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1942376850
Entity Type Individual
Full Name Mr. Charles L Darby
Credential MD
Gender Male
Practice Address 4212 Ne Broadway St
Portland
OR 97213-1460
Practice Telephone 5032498787
Mailing Address 4212 Ne Broadway St
Portland
OR 97213-1460
Mailing Telephone 5032498787
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2006-11-24
Last Update Date 2010-10-28

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 207R00000X Internal Medicine Allopathic & Osteopathic Physicians MD13251 OR

Other Provider Identifier

State Identifier Issuer Type Code
OR 10606-2 MEDICAID

Other Providers CHARLES DARBY

NPI Name Taxonomy Address Enumeration
1437591047 Charles W Darby Hearing Instrument Specialist 19409 Burlingame Rd, Little Rock, AR 72223-9291 2013-07-24

Physician Overview

NPI 1942376850
PAC ID by PECOS 0547214579
Professional Enrollment ID I20101201001179
Full Name Charles L Darby
Organization Legal Name BROADWAY MEDICAL CLINIC LLP
Phone Number 5032498787
Gender M
Medical School BAYLOR COLLEGE OF MEDICINE
Graduation Year 1981
Primary Specialty INTERNAL MEDICINE
Group Practice PAC ID 2466447610
Number of Group Practice Members 16
Accepts Medicare Assignment Y
Report Quality Measures Y
Use Electronic Health Records Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
380061 PROVIDENCE PORTLAND MEDICAL CENTER

Office Location

Street Address 4212 NE BROADWAY ST
City PORTLAND
State OR
Zip Code 97213-1460

Providers in the same location

NPI Name Taxonomy Address Enumeration
1720082316 Broadway Medical Clinic LLP Clinic/Center 4212 Ne Broadway St, Portland, OR 97213-1460 2005-06-10
1487896403 Emily Wasser Puterbaugh Student in an Organized Health Care Education/Training Program 4212 Ne Broadway St, Portland, OR 97213-1422 2009-04-06
1629275508 Melissa Ann Hahn Pediatrics 4212 Ne Broadway St, Portland, OR 97213-1422 2007-07-02
1306964911 Patricia Sandstrom Burke Pediatrics 4212 Ne Broadway St, Portland, OR 97213-1422 2007-03-26
1164563185 Susan Frances Calvert Pharmacist 4212 Ne Broadway St, Portland, OR 97213-1460 2007-02-11
1073670832 Mary Baker Pediatrics 4212 Ne Broadway St, Portland, OR 97213-1460 2007-01-02
1902961907 Charles M Wood Internal Medicine 4212 Ne Broadway St, Portland, OR 97213-1422 2006-12-27
1407916513 Anne M Hirsch Internal Medicine 4212 Ne Broadway St, Portland, OR 97213-1460 2006-12-11
1568539195 Douglas E Renouard Internal Medicine 4212 Ne Broadway St, Portland, OR 97213-1460 2006-11-29
1013084573 Luis A Valls Internal Medicine 4212 Ne Broadway St, Portland, OR 97213-1460 2006-11-29
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1578049631 Credena Health LLC Pharmacy 4805 Ne Glisan St Ste 11n321, Portland, OR 97213 2018-07-12
1023507795 Karissa Lynn Schwartz Speech-Language Pathologist Providence Portland Medical Center, 4805 Ne Glisan St, Portland, OR 97213 2018-05-08
1770094260 Rachel Wysocki Chiropractor 1619 Ne 42nd Ave, Portland, OR 97213 2017-10-24
1861944506 James Livingston Taylor Chiropractor 5212 Ne Sacremento St., Portland, OR 97213 2016-10-28
1962958520 Caitlin Turner Massage Therapist 4317 Ne Tillamook St., Portland, OR 97213 2016-09-01
1891155677 Carissa Marie St. Onge Carneiro Advanced Practice Midwife 545 Ne 47th Ave Ste 102, Portland, OR 97213 2016-03-07
1326407008 Julianna Vermeys Counselor 4605 Ne Fremont St., 209a, Portland, OR 97213 2016-02-23
1881059822 Thomas Michael Barrett Counselor 5228 Ne Hoyt St. Bldg. B, Portland, OR 97213 2015-12-17
1891168399 J Whiskey Northrop Acupuncturist 1716 Ne 42nd Avenue, Temple Medicine Healing, Portland, OR 97213 2015-11-05
1538545082 Jaime Ethan Biava Nurse Practitioner 5228 Ne Hoyt St Bldg B2nd, Portland, OR 97213 2015-08-07
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Taxonomy Information

Taxonomy Code 207R00000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine

Taxonomy Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1134500358 Lan Ban Internal Medicine 9135 Sw Barnes Rd Ste 763, Portland, OR 97225-6777 2015-06-12
1184016099 Wendy W Yu Internal Medicine 9205 Sw Barnes Rd, Suite Mt2800, Portland, OR 97225 2015-03-02
1336551555 Lee Michael Anthony Internal Medicine 9205 Sw Barnes Rd Mt-2800, Portland, OR 97225-6603 2014-05-22
1710307608 Carolyn Hankins Internal Medicine 2222 Nw Lovejoy St Ste 315, Portland, OR 97210-5101 2014-04-18
1063837458 Frances Bubalo Internal Medicine 4535 Sw Tarlow Ct, Portland, OR 97221-3681 2014-02-21
1194147074 Portland Adventist Medical Center Internal Medicine 10201 Se Main St Ste 12, Portland, OR 97216-2937 2014-01-13
1013341064 Columbia Medical Clinic, PC Internal Medicine 9710 Se Washington St Ste B, Portland, OR 97216-8407 2013-08-27
1508209040 Melinda Fry Binkley Internal Medicine 3600 N. Interstate Ave, Portland, OR 97227 2013-04-15
1659714004 Jane Mingjia Zhu Internal Medicine 3147 Sw Sam Jackson Park Rd Fl 3, Portland, OR 97239-3011 2013-04-15
1427391101 Winnie Y Liu Internal Medicine 10101 Se Main St Ste 1001, Portland, OR 97216 2013-04-01
Find all providers in PORTLAND

Competitor

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City PORTLAND
Zip Code 97213

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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