NPIMap

Individual provider Active NPI

Kristy Lane Jessop, M.D.

  • Internal Medicine Physician
  • Corvallis, OR
National Provider Identifier
1740568609
Registry record updated Sep 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
157473 Issued in OR
Practice address
3521 NW Samaritan Dr
Suite 201
Corvallis, OR 97330-4744
Phone
(541) 768-5140
NPI assigned
Jul 26, 2011
Last updated
Sep 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 157473 OR Primary

Addresses

Primary practice location

3521 NW Samaritan Dr
Suite 201
Corvallis, OR 97330-4744

Mailing address

PO Box 1189
Corvallis, OR 97339-1189

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kjessopshankowski5844@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
I20130327000513 OR Practitioner - Internal Medicine 6103061916 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
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

Practice addresses (Care Compare)

3521 NW Samaritan Dr
Corvallis, OR 97330-4744

3600 NW Samaritan Dr
Corvallis, OR 97330-3737

3615 NW Samaritan Dr
Corvallis, OR 97330-3771

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
157473ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Valley Healthcare, Inc. CurrentSince Nov 1, 2022 Accepting new patients
Good Samaritan Hospital Corvallis Internal Medicine CurrentSince Jan 22, 2013 Accepting new patients
Albany General Hospital Current Accepting new patients
Samaritan Pacific Health Services, Inc CurrentSince Nov 1, 2022 Accepting new patients
Samaritan Pacific Health Services, Inc. Current Accepting new patients
Albany General Hospital CurrentSince Mar 1, 2015 Accepting new patients
Samaritan North Lincoln Hospital Current Accepting new patients
Mid-Valley Healthcare Inc Current Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Jan 22, 2013 Accepting new patients
Mid-Valley Healthcare Inc CurrentSince Nov 1, 2022 Accepting new patients
Samaritan North Lincoln Hospital CurrentSince Nov 1, 2022 Accepting new patients
Samaritan Pacific Health Services, Inc Current Accepting new patients
Samaritan North Lincoln Hospital CurrentSince Nov 1, 2022 Accepting new patients
Good Samaritan Hospital Corvallis Current Accepting new patients
Albany General Hospital CurrentSince Mar 1, 2015 Accepting new patients
Samaritan Pacific Health Services Inc CurrentSince Nov 1, 2022 Accepting new patients

Locations

705 Elm St SW
Ste 200
Albany, OR 97321
Phone (541) 812-4850

3521 NW Samaritan Dr
Ste 201
Corvallis, OR 97330
Phone (541) 768-5140

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

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

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

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

3043 NE 28th St
Lincoln City, OR 97367
Phone (541) 994-3661

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

Organizations & group practices 16

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 16

Hospital & facility affiliations 75

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

View all 75

NPI Registry JSON

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

{
    "created_epoch": "1311638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631318400000",
    "number": "1740568609",
    "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": "3521 NW SAMARITAN DR",
            "address_2": "SUITE 201",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973304744",
            "telephone_number": "541-768-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESSOP",
        "first_name": "KRISTY",
        "middle_name": "LANE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-26",
        "last_updated": "2021-09-11",
        "certification_date": "2021-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "157473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kjessopshankowski5844@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "3521 NW Samaritan Dr",
            "address_2": "Suite 201",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973304744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.