Individual provider Active NPI

Destiny Jennifer Gmelch, M.D.

  • Pediatrics Physician
  • Corvallis, OR
National Provider Identifier
1013161413
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD161927 Issued in OR
Practice address
3600 NW Samaritan Dr
Corvallis, OR 97330-3737
Phone
(541) 768-5111
NPI assigned
Nov 11, 2008
Last updated
Nov 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD161927 OR Primary
Pediatrics Physician 208000000X 7148397-1205 UT

Addresses

Primary practice location

3600 NW Samaritan Dr
Corvallis, OR 97330-3737

Mailing address

PO Box 1189
Corvallis, OR 97339-1189

Other practice location 1

390 9th St
Florence, OR 97439-9470
Phone (541) 997-7134

Other names 1

  • Destiny Jennifer Brown Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dgmelch192917@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131003000465 OR Practitioner - Pediatric Medicine 2365676491 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7148397-1205UTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McKenzie Physician Services LLC CurrentSince Sep 11, 2013 Accepting new patients
Peacehealth CurrentSince Nov 20, 2025 Accepting new patients

Locations

1750 Thompson Rd
Coos Bay, OR 97420
Phone (541) 269-0333

390 9th St
Florence, OR 97439
Phone (541) 997-7134

400 9th St
Florence, OR 97439
Phone (541) 997-8412

1460 G St
Springfield, OR 97477
Phone (541) 431-0665

Interoperability endpoints

  • Direct secure messaging: dgmelch@yourcarecommunity.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1226361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1013161413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 NW SAMARITAN DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303737",
            "telephone_number": "541-768-5111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "390 9th St",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "OR",
            "postal_code": "974399470",
            "country_code": "US",
            "telephone_number": "541-997-7134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GMELCH",
        "first_name": "DESTINY",
        "middle_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-11",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD161927",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "7148397-1205",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dgmelch192917@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "3600 NW Samaritan Dr",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973303737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DESTINY",
            "last_name": "BROWN",
            "middle_name": "JENNIFER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.