NPIMap

Organization Active NPI

The Corvallis Clinic P C

  • Multi-Specialty Clinic/Center
  • Corvallis, OR
National Provider Identifier
1649227265
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
THE CORVALLIS CLINIC P C
Practice address
444 NW Elks Dr
Corvallis, OR 97330-3745
Phone
(541) 754-1150
NPI assigned
May 28, 2006
Last updated
Jun 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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

Authorized official

Name
Ms. Emily Castillo
Title
Associate Director Credentialing, O
Phone
(702) 480-2250

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary
Optician 156FX1800X NU

Addresses

Primary practice location

444 NW Elks Dr
Corvallis, OR 97330-3745

Mailing address

444 NW Elks Dr
Corvallis, OR 97330-3745
Phone (541) 754-1150

Other identifiers 1

IdentifierTypeStateIssuer
043158MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, MT, TX, WA, IL6 enrollments

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
O20040203000916 OR Part B Supplier - Clinic/Group Practice 1456244540 Receives reassigned benefits from 179 practitioners
1 other NPI on this enrollment
Practice locations: Albany, OR; Corvallis, OR; Lebanon, OR; Newport, OR; Philomath, OR
O20100930091735 OR DME Supplier - Multi-Specialty - PhysicianDME Supplier - Sports MedicineDME Supplier - Physician - OptometristDME Supplier - Independently-Practicing Physical Therapist 1456244540 Practice locations: Lebanon, OR
O20250917002399 MT Part B Supplier - Clinic/Group Practice 1456244540 Receives reassigned benefits from 2 practitioners
Practice locations: Missoula, MT
O20251011000447 TX Part B Supplier - Clinic/Group Practice 1456244540 Receives reassigned benefits from 1 practitioner
Practice locations: Plano, TX
O20251024001028 WA Part B Supplier - Clinic/Group Practice 1456244540 Receives reassigned benefits from 53 practitioners
1 other NPI on this enrollment
O20260116001652 IL Part B Supplier - Clinic/Group Practice 1456244540 Receives reassigned benefits from 1 practitioner
Practice locations: Lake Forest, IL

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1895 14th Ave SE
Albany, OR 97322

601 Hickory St NW
Albany, OR 97321
Phone (541) 926-3441

2001 NW Monroe Ave
Ste 104
Corvallis, OR 97330
Phone (541) 754-1369

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14349/brand/4/csg/42/fhir/r4

Practitioners & affiliated clinicians

Practitioners 186

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 186

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750982400000",
    "number": "1649227265",
    "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": "973303745",
            "telephone_number": "541-754-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 NW ELKS DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303745",
            "telephone_number": "541-754-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CORVALLIS CLINIC P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A",
        "authorized_official_last_name": "CASTILLO",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "ASSOCIATE DIRECTOR CREDENTIALING, O",
        "authorized_official_telephone_number": "702-480-2250",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043158",
            "state": "OR"
        }
    ],
    "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 27, 2025; 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.