NPIMap

Organization Active NPI

East Linn MRI, LLC

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Lebanon, OR
National Provider Identifier
1417135880
Registry record updated Jul 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X
Legal business name
EAST LINN MRI, LLC
Practice address
505 N Santiam Highway
Lebanon, OR 97355-4363
Phone
(541) 451-6950
Fax
(541) 451-6951
NPI assigned
Feb 7, 2008
Last updated
Jul 30, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2014

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

Authorized official

Name
Becky A. Pape
Title
Ceo
Phone
(541) 768-5009

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X Primary
Magnetic Resonance Imaging Radiologic Technologist 2471M1202X

Addresses

Primary practice location

505 N Santiam Highway
Lebanon, OR 97355-4363

Mailing address

815 NW 9TH Street
Corvallis, OR 97330-6173
Phone (541) 768-6768

Other identifiers 1

IdentifierTypeStateIssuer
500604266MedicaidOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090211000486 OR Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 6305901133 Practice locations: Lebanon, OR

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

815 NW 9th St
Corvallis, OR 97330
Phone (541) 765-5111

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406678400000",
    "number": "1417135880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 NW 9TH STREET",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973306173",
            "telephone_number": "541-768-6768",
            "fax_number": "541-768-6774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 N SANTIAM HIGHWAY",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973554363",
            "telephone_number": "541-451-6950",
            "fax_number": "541-451-6951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST LINN MRI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-07",
        "last_updated": "2014-07-30",
        "status": "A",
        "authorized_official_last_name": "PAPE",
        "authorized_official_first_name": "BECKY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-768-5009"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2471M1202X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Magnetic Resonance Imaging",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500604266",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2014; 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.