NPIMap

Individual provider Active NPI

Jordan Johnson, PA-C

  • Physician Assistant
  • Corvallis, OR
National Provider Identifier
1669085981
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA201748 Issued in OR
Practice address
990 NW Circle Blvd Ste 102
Corvallis, OR 97330-1967
Phone
(541) 768-5486
NPI assigned
Aug 26, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA201748 OR Primary

Addresses

Primary practice location

990 NW Circle Blvd Ste 102
Corvallis, OR 97330-1967

Mailing address

PO Box 1189
Corvallis, OR 97339-1189

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jjohnson196641@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201013001840 OR Practitioner - Physician Assistant 2668892662 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Good Samaritan Hospital CorvallisGroup PAC ID 1557270725, 372 clinicians
Mid-Valley Healthcare IncGroup PAC ID 2769391523, 143 clinicians

Practice addresses (Care Compare)

3600 NW Samaritan Dr
Corvallis, OR 97330-3737

400 N Santiam Hwy
Lebanon, OR 97355
Phone (541) 451-6388

990 NW Circle Blvd
Corvallis, OR 97330-1967

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.14 of 100Reported as group
Quality
85.78
Promoting interoperability
100
Improvement activities
40
Cost
78.31

Merit-based Incentive Payment System (MIPS)

Final score
93.65 of 100Reported as group
Quality
86.8
Promoting interoperability
100
Improvement activities
40
Cost
86.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Valley Healthcare, Inc. CurrentSince Feb 2, 2026 Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Oct 19, 2020 Accepting new patients
Mid-Valley Healthcare Inc CurrentSince Feb 2, 2026 Accepting new patients
Samaritan Pacific Health Services, Inc CurrentSince Feb 1, 2023 Accepting new patients
Mid-Valley Healthcare, Inc. CurrentSince Feb 2, 2026 Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Oct 19, 2020 Accepting new patients

Locations

3600 NW Samaritan Dr
Ste 227
Corvallis, OR 97330
Phone (541) 768-1261

990 NW Circle Blvd
Ste 102
Corvallis, OR 97330
Phone (541) 768-5486

3600 NW Samaritan Dr
Corvallis, OR 97330
Phone (541) 768-4906

777 NW 9th St
Ste 102
Corvallis, OR 97330
Phone (541) 768-6769

325 Park St
Lebanon, OR 97355
Phone (541) 451-7200

930 SW Abbey St
Newport, OR 97365
Phone (541) 265-2244

Interoperability endpoints

  • Direct secure messaging: jjohnson196641@samhealth.direct-ci.com

Organizations & group practices 9

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.

Hospital & facility affiliations 74

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 74

NPI Registry JSON

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

{
    "created_epoch": "1598400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1669085981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 NW CIRCLE BLVD STE 102",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973301967",
            "telephone_number": "541-768-5486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JORDAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-26",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA201748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjohnson196641@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "990 NW Circle Blvd Ste 102",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973301967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.