Active NPI
Tavis Cowan, M.D.
- Family Medicine Physician
- Corvallis, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 042-0011895
- Practice address
- 3680Nwsamaritan Dr
Corvallis, OR 97330-3737 - Phone
- (541) 754-1150
- NPI assigned
- Jun 15, 2006
- Last updated
- Aug 3, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urgent Care Clinic/Center | 261QU0200X | 0420011895 | VT | |
| Family Medicine Physician | 207Q00000X | MD172092 | OR | |
| Family Medicine Physician | 207Q00000X | 042-0011895 | VT | Primary |
Addresses
Primary practice location
3680Nwsamaritan Dr
Corvallis, OR 97330-3737
Mailing address
444Nwelks Dr
Corvallis, OR 97330-3745
Phone (541) 754-1150
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Oregon Health Sciences University School of Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3680 NW Samaritan Dr
Corvallis, OR 97330-3737
Phone (541) 754-1150
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD172092 | OR | MD | Family Medicine Physician |
| 042-0011895 | VT | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Corvallis Clinic P C | Current | Accepting new patients |
Locations
2350 NW Century Dr
Ste 100
Corvallis, OR 97330
Phone (541) 754-1265
3680 NW Samaritan Dr
Corvallis, OR 97330
Phone (541) 754-1282
444 NW Elks Dr
Corvallis, OR 97330
Phone (541) 754-1256
Interoperability endpoints
- https://api.platform.athenahealth.com/14349/brand/4/csg/42/fhir/r4
- tavis.cowan.1@14349.direct.athenahealth.com
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.
-
- Multi-Specialty Clinic/Center
- Corvallis, OR
- NPI 1649227265
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438560000000",
"number": "1306880026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "444NWELKS 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": "3680NWSAMARITAN DR",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973303737",
"telephone_number": "541-754-1150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COWAN",
"first_name": "TAVIS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-15",
"last_updated": "2015-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "261QU0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Urgent Care",
"state": "VT",
"license": "0420011895",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD172092",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "VT",
"license": "042-0011895",
"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 Aug 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.