Willamette Orthopedic Group, LLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

WILLAMETTE ORTHOPEDIC GROUP, LLC

Practice address

591 SE Clay St
Dallas, OR 97338-2812

Phone

(503) 540-6300

Fax

(503) 540-6404

NPI assigned

Feb 18, 2022

Organization subpart

No

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

Authorized official

Name

Lorissa Addabbo

Title

Ceo

Phone

(503) 540-6300

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Hope Orthopedics of Oregon Doing business as

Electronic endpoints 1

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.

• Willamette Orthopedic Group LLC

  • Neurological Surgery Physician
  • McMinnville, OR
  • NPI 1013437862
  NPD tax ID
• Willamette Orthopedic Group LLC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Salem, OR
  • NPI 1588955314
  NPD tax ID
• Willamette Orthopedic Group, LLC

  • Orthopaedic Surgery Physician
  • Dallas, OR
  • NPI 1942926258
  NPD tax ID

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

{
    "created_epoch": "1645142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645747200000",
    "number": "1134874001",
    "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": "591 SE CLAY ST",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "973382812",
            "telephone_number": "503-540-6300",
            "fax_number": "503-540-6404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLAMETTE ORTHOPEDIC GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-18",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A",
        "authorized_official_last_name": "ADDABBO",
        "authorized_official_first_name": "LORISSA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "503-540-6300"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278220",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Dallas",
            "affiliation": "N",
            "address_1": "591 SE Clay St",
            "city": "Dallas",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973382812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Hope Orthopedics of Oregon",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hope Orthopedics of Oregon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shelby White, PSS
• Kimberli Ann Wicks, LPC
• Lindsey Widmer
• Sharalee Gail Wildman, RMT, LMT
• Willamette Orthopedic Group LLC
• Willamette Orthopedic Group, LLC
• Willamette Urology PC
• Robert Franklin Willey, MD
• Annabel Willis
• Gayle Ray Wilson, MD

• Orthopaedic Surgery Physician in Dallas, OR
• Providers in Dallas, OR by specialty
• Orthopaedic Surgery Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; 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.