NPIMap

Organization Active NPI

Act Beyond Pain, LLC

  • Clinical Social Worker
  • Corvallis, OR
National Provider Identifier
1508216573
Registry record updated Jun 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4077 Issued in OR
Legal business name
ACT BEYOND PAIN, LLC
Practice address
4655 NW Queens Ave
Corvallis, OR 97330-3234
Phone
(503) 428-0340
NPI assigned
Jun 20, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2016

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

Authorized official

Name
Ms. Sandra VeronickNPI 1295924009
Title
Co-Owner
Phone
(503) 428-0340

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X 4077 OR Primary

Addresses

Primary practice location

4655 NW Queens Ave
Corvallis, OR 97330-3234

Mailing address

4655 NW Queens Ave
Corvallis, OR 97330-3234

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466380800000",
    "number": "1508216573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4655 NW QUEENS AVE",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4655 NW QUEENS AVE",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303234",
            "telephone_number": "503-428-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACT BEYOND PAIN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-20",
        "last_updated": "2016-06-20",
        "status": "A",
        "authorized_official_last_name": "VERONICK",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "503-428-0340",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "4077",
            "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 Jun 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.