Willamette Valley Pediatrics

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD27741 Issued in OR

Legal business name

WILLAMETTE VALLEY PEDIATRICS

Practice address

1123 Hill St SE Ste B
Albany, OR 97322-3292

Phone

(541) 207-7431

Fax

(541) 644-5017

NPI assigned

Mar 5, 2018

Organization subpart

No

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

Authorized official

Name

Barry Miller

Title

Admin

Phone

(325) 513-9265

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

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.

• Simon Thomas Bachofner, FNP-C

  • Family Medicine Physician
  • Albany, OR
  • NPI 1912654179

  Pediatrics

  NPD
• Christina M. Miller, M.D.

  • Pediatrics Physician
  • Albany, OR
  • NPI 1053506758
  NPD
• Dana L. Kosmala, D.O.

  • Pediatrics Physician
  • Albany, OR
  • NPI 1275575508
  NPD (past)
• Philip A. Prewette, M.A.

  • Marriage & Family Therapist
  • Albany, OR
  • NPI 1437201993
  NPD (past)

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

{
    "created_epoch": "1520208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632960000000",
    "number": "1427550557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1123 HILL ST SE STE B",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973223292",
            "telephone_number": "541-207-7431",
            "fax_number": "541-644-5017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1123 HILL ST SE STE B",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973223292",
            "telephone_number": "541-207-7431",
            "fax_number": "541-644-5017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLAMETTE VALLEY PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-05",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "BARRY",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "325-513-9265"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD27741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Wilcox, RN
• Joslynn Wilder
• David Wilkinson, LMT, CMT
• Willamette Orthotics & Prosthetics, LLC (Summit Orthotics & Prosthetics)
• Willamette Valley Home Care, Inc. (Visiting Angels of Willamette Valley)
• Willamette Valley Spine and Strength LLC
• Willamette Valley Spine Solutions, PC
• Laura Willcoxen, LPC
• Jaime Nicole Williams, B.ED
• Sylvia Williamson, L.M.T.

• Pediatrics Physician in Albany, OR
• Providers in Albany, OR by specialty
• Pediatrics Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.

Verify at the official NPI Registry.