Susan Marie McMahon

Primary specialty

Orthotic FitterTaxonomy code 225000000X

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

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Donna Bella LLC

  • Prosthetic/Orthotic Supplier
  • Corvallis, OR
  • NPI 1033448907
  NPD Authorized official

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": []
}

• Tristan McKibben
• Cody Lee McKinnis
• Elizabeth Larie McMahan
• Katelyn Rose McMahan, MD
• Joy L McMahon, LCSW
• Ashley Hennessey McMann, M.D.
• Candace J McMaster I
• Peter Troy McMillan, DPT
• Howland McNelia
• Kristy McPeak, LPC INTERN, NCC

• Orthotic Fitter in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Orthotic Fitter in Oregon

• 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.

Verify at the official NPI Registry.