NPIMap

Organization Active NPI

Good Samaritan Hospital Corvallis

  • Family Medicine Physician
  • Corvallis, OR
National Provider Identifier
1710244843
Registry record updated Jan 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GOOD SAMARITAN HOSPITAL CORVALLIS
Practice address
325 Valley Football Ctr
Room 122-123
Corvallis, OR 97331-8544
Phone
(541) 737-4527
Fax
(541) 737-0864
NPI assigned
Apr 13, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2015

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

Authorized official

Name
Becky Pape
Title
Coo
Phone
(541) 768-5009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

325 Valley Football Ctr
Room 122-123
Corvallis, OR 97331-8544

Mailing address

325 Valley Football Ctr
Room 122-123
Corvallis, OR 97331-8544
Phone (541) 737-4527

Other identifiers 1

IdentifierTypeStateIssuer
500651544MedicaidOR

Other names 1

  • Samaritan Sports Medicine-V Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031125000163 OR Part B Supplier - Clinic/Group Practice 1557270725 Receives reassigned benefits from 589 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Corvallis, OR; Albany, OR

National Provider Directory

National Provider Directory
Tax ID family
Good Samaritan Regional Med50 organizations share this tax ID, including this one

Other organizations with this tax ID 49

Organizations that report the same tax identification number in the National Provider Directory.

View all 49

Locations

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

845 SW 30th St
Corvallis, OR 97331
Phone (541) 768-7700

Practitioners & affiliated clinicians

Practitioners 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1334275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422576000000",
    "number": "1710244843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 VALLEY FOOTBALL CTR",
            "address_2": "ROOM 122-123",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973318544",
            "telephone_number": "541-737-4527",
            "fax_number": "541-737-0864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 VALLEY FOOTBALL CTR",
            "address_2": "ROOM 122-123",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973318544",
            "telephone_number": "541-737-4527",
            "fax_number": "541-737-0864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN HOSPITAL CORVALLIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-13",
        "last_updated": "2015-01-30",
        "status": "A",
        "authorized_official_last_name": "PAPE",
        "authorized_official_first_name": "BECKY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "541-768-5009"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500651544",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Samaritan Sports Medicine-V",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 30, 2015; 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.