NPIMap

Organization Active NPI

Corvallis Clinic PC

Doing business as Corvallis Clinic Physical Therapy Heritage Mall DME only

  • Durable Medical Equipment & Medical Supplies
  • Albany, OR
National Provider Identifier
1093589798
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
CORVALLIS CLINIC PC
Doing business as
Corvallis Clinic Physical Therapy Heritage Mall DME only
Practice address
1815 14TH Ave SE
Albany, OR 97322-8502
Phone
(541) 754-1265
NPI assigned
Nov 13, 2023
Last updated
Jan 25, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
CORVALLIS CLINIC PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Authorized official

Name
James Kaech
Title
Chief Executive Officer
Phone
(541) 754-1374

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

1815 14TH Ave SE
Albany, OR 97322-8502

Mailing address

444 NW Elks Dr
Corvallis, OR 97330-3745
Phone (541) 754-1374

Other names 1

  • Corvallis Clinic Physical Therapy Heritage Mall DME only Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Corvallis Clinic PC18 organizations share this tax ID, including this one
Part of
Corvallis Clinic PC

Other organizations with this tax ID 17

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

View all 17

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1699833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706140800000",
    "number": "1093589798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 NW ELKS DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303745",
            "telephone_number": "541-754-1374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 14TH AVE SE",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973228502",
            "telephone_number": "541-754-1265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORVALLIS CLINIC PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CORVALLIS CLINIC PC",
        "enumeration_date": "2023-11-13",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A",
        "authorized_official_last_name": "KAECH",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "541-754-1374"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corvallis Clinic Physical Therapy Heritage Mall DME only",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albany, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; 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.