Corvallis Pediatrics, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

CORVALLIS PEDIATRICS, LLC

Practice address

1873 NW Kings Blvd
Corvallis, OR 97330-1907

Phone

(541) 745-8715

NPI assigned

Jul 10, 2025

Organization subpart

No

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

Authorized official

Name

Kourtney Hanks, FNP-C, CNMNPI 1013371707

Title

Nurse Practitioner

Phone

(541) 745-8715

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

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

• Kourtney L Hanks, CNM/FNP

  • Nurse Practitioner
  • Corvallis, OR
  • NPI 1013371707
  NPD Authorized official

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

{
    "created_epoch": "1752105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752105600000",
    "number": "1720979651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1873 NW KINGS BLVD",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973301907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1873 NW KINGS BLVD",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973301907",
            "telephone_number": "541-745-8715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORVALLIS PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-10",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A",
        "authorized_official_last_name": "HANKS",
        "authorized_official_first_name": "KOURTNEY",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "541-745-8715",
        "authorized_official_credential": "FNP-C, CNM"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013371707",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Corvallis Internal Medicine, PC
• Corvallis Medical Group LLC (Corvallis Pain Management)
• Corvallis MRI a Joint Venture (Corvallis MRI)
• Corvallis Natural Medicine, Inc
• Corvallis Neuropsychology LLC
• Corvallis Physical Therapy Inc
• Corvallis Radiology PC
• Corvallis School District 509J
• Corvallis School District 509J
• Corvallis School District 509J

• Primary Care Clinic/Center in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Primary Care Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.