Shawn R. Hathaway, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD23849 Issued in OR

Practice address

3680 NW Samaritan Dr
Corvallis, OR 97330-3737

Phone

(541) 754-1278

Fax

(541) 754-1512

NPI assigned

Jun 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14349/brand/4/csg/42/fhir/r4
• Direct secure messaging: shawn.hathaway.1@14349.direct.athenahealth.com

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.

• The Corvallis Clinic P C

  • Multi-Specialty Clinic/Center
  • Corvallis, OR
  • NPI 1649227265
  Medicare reassignment NPD
• The Corvallis Clinic P C

  • Urgent Care Clinic/Center
  • Corvallis, OR
  • NPI 1679362198
  NPD
• Firstcare Medical Foundation

  • Family Medicine Physician
  • Albany, OR
  • NPI 1740216498

  Pediatrics

  NPD (past)
• Good Samaritan Hospital Corvallis

  • Durable Medical Equipment & Medical Supplies
  • Corvallis, OR
  • NPI 1477851186
  NPD (past)

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1609818202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 NW ELKS DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303758",
            "telephone_number": "541-754-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3680 NW SAMARITAN DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303737",
            "telephone_number": "541-754-1278",
            "fax_number": "541-754-1512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATHAWAY",
        "first_name": "SHAWN",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-11",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD23849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shathaway3864@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "777 NW 9th St",
            "address_2": "Suite 320",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973306169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joanne Marie Hastings, LMT
• Lenore S Hata, DDS
• Zach Hatch, ATC
• Charles Lewis Hatcher Jr., BS
• Kyle Llemalt Hatchett
• Heather Anne Haugan, FNP-C
• Sarah Hausmann
• Linda Havard
• Richard C. Havard, M.D.
• April Hawk-Vera

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.