Corvallis Medical Group LLC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

CORVALLIS MEDICAL GROUP LLC

Practice address

800 NE Circle Blvd
Corvallis, OR 97330-4256

Phone

(541) 286-4742

Fax

(833) 450-5933

NPI assigned

May 11, 2015

Organization subpart

No

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

Authorized official

Name

Julia Bull Rask, PE

Title

Chief Financial Officer

Phone

(541) 368-3032

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• CORVALLIS PAIN MANAGEMENT Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 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

Locations

Practitioners 5

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

• David Kenneth Frome, MD

  • Anesthesiology Physician
  • Corvallis, OR
  • NPI 1942665138

  Interventional Pain Medicine

  Medicare reassignment Care Compare group NPD
• Patrick Rask, M.D.

  • Interventional Pain Medicine Physician
  • Corvallis, OR
  • NPI 1427188309
  Medicare reassignment Care Compare group NPD
• Christopher Jason Smith, P.A.

  • Interventional Pain Medicine Physician
  • Corvallis, OR
  • NPI 1053744524
  Medicare reassignment Care Compare group NPD
• Jarod Smith, D.N.P., A.R.N.P.,F.N

  • Interventional Pain Medicine Physician
  • Corvallis, OR
  • NPI 1891191672
  Medicare reassignment Care Compare group NPD
• Jordan S Garman, D.O.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Mather, CA
  • NPI 1710240791

  OR

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713744000000",
    "number": "1740668649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 NE CIRCLE BLVD",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973304256",
            "telephone_number": "541-286-4742",
            "fax_number": "833-450-5933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 NE CIRCLE BLVD",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973304256",
            "telephone_number": "541-286-4742",
            "fax_number": "833-450-5933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORVALLIS MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-11",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A",
        "authorized_official_last_name": "RASK",
        "authorized_official_first_name": "JULIA",
        "authorized_official_middle_name": "BULL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "541-368-3032",
        "authorized_official_credential": "PE"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130103",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CORVALLIS PAIN MANAGEMENT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Interventional Pain Medicine Physician in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Interventional Pain Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.