NPIMap

Organization Active NPI

Good Samaritan Hospital Corvallis

Doing business as Samaritan Athletic Medicine Center

  • Sports Physical Therapist
  • Corvallis, OR
National Provider Identifier
1013326537
Registry record updated Jan 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physical TherapistTaxonomy code 2251S0007X
Legal business name
GOOD SAMARITAN HOSPITAL CORVALLIS
Doing business as
Samaritan Athletic Medicine Center
Practice address
845 SW 30TH Street
Corvallis, OR 97331-8629
Phone
(541) 768-7700
Fax
(541) 768-9784
NPI assigned
Aug 8, 2014
Last updated
Jan 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2015

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

Authorized official

Name
Becky Pape
Title
Coo
Phone
(541) 768-5009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251S0007X Primary

Addresses

Primary practice location

845 SW 30TH Street
Corvallis, OR 97331-8629

Mailing address

PO Box 1189
Corvallis, OR 97339-1189
Phone (541) 768-7700

Other names 1

  • Samaritan Athletic Medicine Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031125000163 OR Part B Supplier - Clinic/Group Practice 1557270725 Receives reassigned benefits from 589 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Corvallis, OR; Albany, OR

National Provider Directory

National Provider Directory

Locations

114 Gill Coliseum
Rm 6263
Corvallis, OR 97331
Phone (541) 737-4527

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1407456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422576000000",
    "number": "1013326537",
    "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",
            "telephone_number": "541-768-7700",
            "fax_number": "541-768-9784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 SW 30TH STREET",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973318629",
            "telephone_number": "541-768-7700",
            "fax_number": "541-768-9784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN HOSPITAL CORVALLIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-08",
        "last_updated": "2015-01-30",
        "status": "A",
        "authorized_official_last_name": "PAPE",
        "authorized_official_first_name": "BECKY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "541-768-5009"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Samaritan Athletic Medicine Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Corvallis, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.