NPIMap

Organization Active NPI

Samaritan Health Services

  • Health Service Clinic/Center
  • Albany, OR
National Provider Identifier
1114469103
Registry record updated Nov 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
SAMARITAN HEALTH SERVICES
Practice address
620 Elm St SW # 2
Albany, OR 97321-1986
Phone
(541) 812-4839
NPI assigned
Nov 8, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2016

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

Authorized official

Name
Jonathan Douglas Wymore, RD, LDNPI 1912449919
Title
Registered Dietitian
Phone
(541) 232-9615

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary
General Acute Care Hospital 282N00000X

Addresses

Primary practice location

620 Elm St SW # 2
Albany, OR 97321-1986

Mailing address

117 SW 4TH St Apt 2
Corvallis, OR 97333-4717
Phone (541) 232-9615

Other identifiers 2

IdentifierTypeStateIssuer
86065504OtherCOMMISION ON DIETETIC REGISTRATION
LDD10175002OtherOROREGON DIETETIC LICENSURE

National Provider Directory

National Provider Directory
Tax ID family
Community Care Services456 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 4

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

620 Elm St SW
#2
Albany, OR 97321
Phone (541) 812-4839

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1478563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478563200000",
    "number": "1114469103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 SW 4TH ST APT 2",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973334717",
            "telephone_number": "541-232-9615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 ELM ST SW # 2",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211986",
            "telephone_number": "541-812-4839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITAN HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-08",
        "last_updated": "2016-11-08",
        "status": "A",
        "authorized_official_last_name": "WYMORE",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "541-232-9615",
        "authorized_official_credential": "RD, LD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMISION ON DIETETIC REGISTRATION",
            "identifier": "86065504",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON DIETETIC LICENSURE",
            "identifier": "LDD10175002",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Nov 8, 2016; 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.