NPIMap

Organization Active NPI

Willamette Orthopedic Group LLC

  • Neurological Surgery Physician
  • McMinnville, OR
National Provider Identifier
1013437862
Registry record updated Jun 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
WILLAMETTE ORTHOPEDIC GROUP LLC
Practice address
254 NE Norton LN
McMinnville, OR 97128-8470
Phone
(503) 540-6300
Fax
(503) 540-6404
NPI assigned
Jun 22, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2017

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

Authorized official

Name
Mrs. Lorissa Addabbo, CEO
Title
Ceo
Phone
(503) 540-6470

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207T00000X Primary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X

Addresses

Primary practice location

254 NE Norton LN
McMinnville, OR 97128-8470

Mailing address

1600 State St
Salem, OR 97301-4257
Phone (503) 540-6300

Other identifiers 1

IdentifierTypeStateIssuer
278220MedicaidOR

Other names 1

  • Hope Orthopedics of Oregon Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Hope Orthopedics of Oregon4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

254 NE Norton Ln
McMinnville, OR 97128
Phone (503) 472-6161

NPI Registry JSON

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

{
    "created_epoch": "1498089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498089600000",
    "number": "1013437862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 STATE ST",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014257",
            "telephone_number": "503-540-6300",
            "fax_number": "503-540-6404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 NE NORTON LN",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971288470",
            "telephone_number": "503-540-6300",
            "fax_number": "503-540-6404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLAMETTE ORTHOPEDIC GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-22",
        "last_updated": "2017-06-22",
        "status": "A",
        "authorized_official_last_name": "ADDABBO",
        "authorized_official_first_name": "LORISSA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "503-540-6470",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278220",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hope Orthopedics of Oregon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in McMinnville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.