NPIMap

Organization Active NPI

Good Samaritan Hospital Corvallis

Doing business as Samaritan Family Medicine, Southwest

  • Family Medicine Physician
  • Corvallis, OR
National Provider Identifier
1376809475
Registry record updated Jan 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GOOD SAMARITAN HOSPITAL CORVALLIS
Doing business as
Samaritan Family Medicine, Southwest
Practice address
5234 SW Philomath Blvd
Corvallis, OR 97333-1042
Phone
(541) 757-2585
NPI assigned
Apr 3, 2012
Last updated
Jan 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2015

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

Authorized official

Name
Becky Pape
Title
Coo
Phone
(541) 768-5009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

5234 SW Philomath Blvd
Corvallis, OR 97333-1042

Mailing address

5234 SW Philomath Blvd
Corvallis, OR 97333-1042
Phone (541) 757-2585

Other names 1

  • Samaritan Family Medicine, Southwest Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031125000163 OR Part B Supplier - Clinic/Group Practice 1557270725 Receives reassigned benefits from 589 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Corvallis, OR; Albany, OR

National Provider Directory

National Provider Directory
Tax ID family
Wayne Phillips50 organizations share this tax ID, including this one

Other organizations with this tax ID 49

Organizations that report the same tax identification number in the National Provider Directory.

View all 49

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422576000000",
    "number": "1376809475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5234 SW PHILOMATH BLVD",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973331042",
            "telephone_number": "541-757-2585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5234 SW PHILOMATH BLVD",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973331042",
            "telephone_number": "541-757-2585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN HOSPITAL CORVALLIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-03",
        "last_updated": "2015-01-30",
        "status": "A",
        "authorized_official_last_name": "PAPE",
        "authorized_official_first_name": "BECKY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "541-768-5009"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Samaritan Family Medicine, Southwest",
            "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 Jan 30, 2015; 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.