Individual provider Active NPI

Lisa Goodrich, PT

  • Physical Therapist
  • Corvallis, OR
National Provider Identifier
1386815736
Registry record updated Nov 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1560 Issued in OR
Practice address
815 NW 9TH St
Suite180
Corvallis, OR 97330-6173
Phone
(541) 768-5157
NPI assigned
Mar 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1560 OR Primary

Addresses

Primary practice location

815 NW 9TH St
Suite180
Corvallis, OR 97330-6173

Mailing address

PO Box 1189
Corvallis, OR 97339-1189

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lgoodrich4895@samhealth.direct-ci.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170216002353 OR Practitioner - Physical Therapist in Private Practice 3678856614 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1560ORMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Hospital Corvallis Physical Therapist CurrentSince Jul 15, 2022 Accepting new patients
Good Samaritan Hospital Corvallis Current Accepting new patients

Locations

3600 NW Samaritan Dr
Ste 227
Corvallis, OR 97330
Phone (541) 768-1261

815 NW 9th St
Ste 180
Corvallis, OR 97330
Phone (541) 768-5157

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1386815736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 NW 9TH ST",
            "address_2": "SUITE180",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973306173",
            "telephone_number": "541-768-5157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODRICH",
        "first_name": "LISA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-13",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "1560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lgoodrich4895@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "815 NW 9th St",
            "address_2": "Suite180",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973306173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Nov 9, 2020; 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.