NPIMap

Individual provider Active NPI

Charla Staggs, PA-C

  • Physician Assistant
  • Corvallis, OR
National Provider Identifier
1215022512
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01241 Issued in OR
Practice address
3680 NW Samaritan Dr
Corvallis, OR 97330-3737
Phone
(541) 754-1150
Fax
(541) 753-1789
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA01241 OR Primary

Addresses

Primary practice location

3680 NW Samaritan Dr
Corvallis, OR 97330-3737

Mailing address

444 NW Elks Dr
Corvallis, OR 97330-3745
Phone (541) 754-1150

Other identifiers 1

IdentifierTypeStateIssuer
100509769MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20071114000081 OR Practitioner - Physician Assistant 6709883499 Reassigns benefits to 2 organizations
I20231221001994 WA Practitioner - Physician Assistant 6709883499 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Touro Un College of Osteopathic Medicine, Vallejo, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Corvallis Clinic P CGroup PAC ID 1456244540, 128 clinicians

Practice addresses (Care Compare)

3680 NW Samaritan Dr
Corvallis, OR 97330-3737
Phone (541) 754-1150

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.16 of 100Reported as group
Quality
84.81
Promoting interoperability
100
Improvement activities
40
Cost
75.71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA01241ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Radia Imaging Center Holdings LLC CurrentSince Jan 30, 2024 Accepting new patients
Firstcare Medical Foundation Physician Assistant PastSince Sep 1, 2004 Accepting new patients
Good Samaritan Hospital Corvallis Past Accepting new patients
Gastroenterology Center of Nevada, LLP (Desai) Past Accepting new patients

Locations

19020 33rd Ave W
Ste 210
Lynnwood, WA 98036
Phone 42556315001

1229 Madison St
Ste 900
Seattle, WA 98104
Phone (206) 292-6233

Interoperability endpoints

  • Direct secure messaging: cstaggs636141@direct.peacehealth.org
  • Direct secure messaging: charla.staggs.1@14349.direct.athenahealth.com

Organizations & group practices 10

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1215022512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 NW ELKS DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303745",
            "telephone_number": "541-754-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3680 NW SAMARITAN DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303737",
            "telephone_number": "541-754-1150",
            "fax_number": "541-753-1789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAGGS",
        "first_name": "CHARLA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA01241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100509769",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.