Active NPI
Susan Marie McMahon
- Orthotic Fitter
- Corvallis, OR
National Provider Identifier
1154650463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthotic Fitter
- Practice address
- 117 NW 2ND St
Corvallis, OR 97330-4719 - Phone
- (541) 752-9649
- Fax
- (541) 753-0559
- NPI assigned
- Dec 15, 2009
- Reactivated
- Dec 20, 2011
- Last updated
- Dec 20, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotic Fitter | 225000000X | Primary |
Addresses
Primary practice location
117 NW 2ND St
Corvallis, OR 97330-4719
Mailing address
117 NW 2ND St
Corvallis, OR 97330-4719
Phone (541) 752-9649
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Donna Bella LLC | Current | Accepting new patients |
Locations
117 NW 2nd St
Corvallis, OR 97330
Phone (541) 752-9649
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1260835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324339200000",
"number": "1154650463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 NW 2ND ST",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973304719",
"telephone_number": "541-752-9649",
"fax_number": "541-753-0559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 NW 2ND ST",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973304719",
"telephone_number": "541-752-9649",
"fax_number": "541-753-0559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMAHON",
"first_name": "SUSAN",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-12-15",
"last_updated": "2011-12-20",
"deactivation_date": "2010-01-05",
"reactivation_date": "2011-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "225000000X",
"taxonomy_group": "",
"desc": "Orthotic Fitter",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corvallis, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.