NPIMap

Individual provider Active NPI

Kelly Dale Carrier

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1144757311
Registry record updated Aug 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO198390 Issued in OR
Practice address
1200 NW 23Rd Ave
Portland, OR 97210-2906
Phone
(503) 413-6892
NPI assigned
May 18, 2017
Last updated
Aug 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X DO198390 OR Primary

Addresses

Primary practice location

1200 NW 23Rd Ave
Portland, OR 97210-2906

Mailing address

230 McKenzie PL
Harrisburg, OR 97446-9570

Other practice location 1

3600 NW Samaritan Dr
Corvallis, OR 97330-3737
Phone (541) 768-5111

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kcarrier201579@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201124001077 OR Practitioner - Internal Medicine 2365710340 Reassigns benefits to 11 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Pacific NW Un of HS, Col of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Good Samaritan Hospital CorvallisGroup PAC ID 1557270725, 372 clinicians

Practice addresses (Care Compare)

3600 NW Samaritan Dr
Corvallis, OR 97330-3737

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.14 of 100Reported as group
Quality
85.78
Promoting interoperability
100
Improvement activities
40
Cost
78.31

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO198390ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Hospital Corvallis Internal Medicine CurrentSince Jul 18, 2021 Accepting new patients
Albany General Hospital Current Accepting new patients
Samaritan Pacific Health Services, Inc CurrentSince Jul 18, 2021 Accepting new patients
Samaritan Pacific Health Services, Inc. Current Accepting new patients
Albany General Hospital CurrentSince Jul 18, 2021 Accepting new patients
Samaritan North Lincoln Hospital Current Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Oct 27, 2021 Accepting new patients
Mid-Valley Healthcare, Inc. CurrentSince Jul 18, 2021 Accepting new patients
Silverton Health CurrentSince Oct 27, 2021 Accepting new patients
Silverton Health Current Accepting new patients
Samaritan North Lincoln Hospital CurrentSince Jul 18, 2021 Accepting new patients
Mid-Valley Healthcare Inc Current Accepting new patients
Albany General Hospital CurrentSince Jul 18, 2021 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Oct 27, 2021 Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Jul 18, 2021 Accepting new patients
Mid-Valley Healthcare Inc CurrentSince Jul 18, 2021 Accepting new patients
Samaritan Pacific Health Services, Inc CurrentSince Jul 18, 2021 Accepting new patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients
Samaritan North Lincoln Hospital CurrentSince Jul 18, 2021 Accepting new patients
Silverton Health CurrentSince Oct 27, 2021 Accepting new patients
Legacy Clinics LLC Internal Medicine CurrentSince Aug 20, 2020 Accepting new patients
Good Samaritan Hospital Corvallis Current Accepting new patients

Locations

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

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

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

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

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

1200 NW 23rd Ave
Portland, OR 97210
Phone (503) 413-7074

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

2800 N Vancouver Ave
Ste 230
Portland, OR 97227
Phone (503) 413-2901

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

342 Fairview St
Silverton, OR 97381
Phone (503) 525-7660

Interoperability endpoints

  • Direct secure messaging: kcarrier201579@samhealth.direct-ci.com

Organizations & group practices 22

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

View all 22

Hospital & facility affiliations 35

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1495065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1144757311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 MCKENZIE PL",
            "city": "HARRISBURG",
            "state": "OR",
            "postal_code": "974469570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 NW 23RD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102906",
            "telephone_number": "503-413-6892"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 NW Samaritan Dr",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973303737",
            "country_code": "US",
            "telephone_number": "541-768-5111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARRIER",
        "first_name": "KELLY",
        "middle_name": "DALE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-18",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "DO198390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcarrier201579@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "3600 NW Samaritan Dr",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973303737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.