Individual provider Active NPI

Lon McQuillan, M.D.

  • Pediatrics Physician
  • Corvallis, OR
National Provider Identifier
1124062955
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD25013 Issued in OR
Practice address
777 NW 9TH St
Suite 320
Corvallis, OR 97330-6169
Phone
(541) 768-4900
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD25013 OR Primary

Addresses

Primary practice location

777 NW 9TH St
Suite 320
Corvallis, OR 97330-6169

Mailing address

PO Box 1189
Corvallis, OR 97339-1189

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lmcquillan6585@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
I20041025000405 OR Practitioner - Pediatric Medicine 7719948546 Reassigns benefits to 8 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD25013ORMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Pacific Health Services, Inc Current Accepting new patients
Mid-Valley Healthcare Inc Current Accepting new patients
Mid-Valley Healthcare, Inc. CurrentSince Apr 1, 2022 Accepting new patients
Samaritan Pacific Health Services Inc CurrentSince Apr 1, 2022 Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Jul 31, 2018 Accepting new patients
Samaritan North Lincoln Hospital CurrentSince Apr 1, 2022 Accepting new patients
Mid-Valley Healthcare Inc CurrentSince Apr 1, 2022 Accepting new patients
Albany General Hospital CurrentSince Mar 20, 2020 Accepting new patients
Good Samaritan Hospital Corvallis Current Accepting new patients
Samaritan North Lincoln Hospital CurrentSince Apr 1, 2022 Accepting new patients
Albany General Hospital CurrentSince Mar 20, 2020 Accepting new patients
Samaritan Pacific Health Services, Inc CurrentSince Apr 1, 2022 Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Jul 31, 2018 Accepting new patients
Albany General Hospital Current Accepting new patients
Samaritan Pacific Health Services, Inc. Current Accepting new patients
Firstcare Medical Foundation Pediatrics Past Accepting new patients

Locations

705 Elm St SW
Ste 200
Albany, OR 97321
Phone (541) 812-4850

3600 NW Samaritan Dr
Ste 227
Corvallis, OR 97330
Phone (541) 768-1261

777 NW 9th St
Ste 320
Corvallis, OR 97330
Phone (541) 768-1840

3600 NW Samaritan Dr
Corvallis, OR 97330
Phone (541) 768-4906

777 NW 9th St
Ste 102
Corvallis, OR 97330
Phone (541) 768-6769

425 N Santiam Hwy
Lebanon, OR 97355
Phone (541) 451-6960

325 Park St
Lebanon, OR 97355
Phone (541) 451-7200

3043 NE 28th St
Lincoln City, OR 97367
Phone (541) 994-3661

930 SW Abbey St
Newport, OR 97365
Phone (541) 265-2244

Organizations & group practices 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1124062955",
    "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": "777 NW 9TH ST",
            "address_2": "SUITE 320",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973306169",
            "telephone_number": "541-768-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCQUILLAN",
        "first_name": "LON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD25013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmcquillan6585@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "777 NW 9th St",
            "address_2": "Suite 320",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973306169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.