Active NPI
Keith Pappas Poulsen, DVM, PHD
- Veterinarian
- Corvallis, OR
National Provider Identifier
1225387129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Veterinarian
- License
- 5662
- Practice address
- 700 SW 30TH St
Corvallis, OR 97331-8628 - Phone
- (608) 338-6444
- NPI assigned
- Sep 6, 2012
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Veterinarian | 174M00000X | 5662 | WI | Primary |
Addresses
Primary practice location
700 SW 30TH St
Corvallis, OR 97331-8628
Mailing address
700 SW 30TH St
Corvallis, OR 97331-8628
Phone (608) 338-6444
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
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346889600000",
"number": "1225387129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 SW 30TH ST",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973318628",
"telephone_number": "608-338-6444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 SW 30TH ST",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973318628",
"telephone_number": "608-338-6444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POULSEN",
"first_name": "KEITH",
"middle_name": "PAPPAS",
"name_prefix": "Dr.",
"credential": "DVM, PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-09-06",
"last_updated": "2012-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "174M00000X",
"taxonomy_group": "",
"desc": "Veterinarian",
"state": "WI",
"license": "5662",
"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 Sep 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.