NPIMap

Organization Active NPI

Albany General Hospital

Doing business as Heartspring Wellness Center

  • Family Medicine Physician
  • Corvallis, OR
National Provider Identifier
1154697001
Registry record updated Dec 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ALBANY GENERAL HOSPITAL
Doing business as
Heartspring Wellness Center
Practice address
990 NW Circle Blvd
Suite 201
Corvallis, OR 97330-1967
Phone
(541) 768-6412
Fax
(541) 768-6643
NPI assigned
Mar 26, 2012
Last updated
Dec 18, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2012

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

Authorized official

Name
David Triebes
Title
Ceo
Phone
(541) 768-5009

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X
Acupuncturist 171100000X
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

990 NW Circle Blvd
Suite 201
Corvallis, OR 97330-1967

Mailing address

990 NW Circle Blvd
Suite 201
Corvallis, OR 97330-1967
Phone (541) 768-6412

Other names 1

  • Heartspring Wellness Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040310000310 OR Part B Supplier - Clinic/Group Practice 9931097987 Receives reassigned benefits from 473 practitioners
31 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Albany, OR

Other NPIs on the same Medicare enrollment 31

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 31

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1332720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355788800000",
    "number": "1154697001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 NW CIRCLE BLVD",
            "address_2": "SUITE 201",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973301967",
            "telephone_number": "541-768-6412",
            "fax_number": "541-768-6643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 NW CIRCLE BLVD",
            "address_2": "SUITE 201",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973301967",
            "telephone_number": "541-768-6412",
            "fax_number": "541-768-6643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBANY GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-26",
        "last_updated": "2012-12-18",
        "status": "A",
        "authorized_official_last_name": "TRIEBES",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-768-5009"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heartspring Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.