Active NPI
Elinor J Tatham, M.D.
- Family Medicine Physician
- Corvallis, OR
National Provider Identifier
1760435135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD00033246
- Practice address
- 850 SW 2TH Street
Corvallis, OR 97331 - Phone
- (541) 737-9355
- Fax
- (541) 737-9665
- NPI assigned
- May 18, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD152758 | OR | |
| Family Medicine Physician | 207Q00000X | MD00033246 | WA | Primary |
Addresses
Primary practice location
850 SW 2TH Street
Corvallis, OR 97331
Mailing address
850 SW 26TH St
Corvallis, OR 97331-8624
Phone (541) 737-9355
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1095389 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD152758 | OR | MD | Family Medicine Physician |
| MD00033246 | WA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lane County Oregon | Current | Accepting new patients | |
| Madrona Hill Urgent Care LLC | Past | Accepting new patients | |
| Firstcare Medical Foundation | Family Medicine | Past | Accepting new patients |
| Port Gamble S'Klallam Tribe | Past | Accepting new patients | |
| Port Gamble S'Klallam Tribe | Past | Accepting new patients | |
| Good Samaritan Hospital Corvallis | Past | Accepting new patients |
Locations
1022 Green Acres Rd
Eugene, OR 97408
Phone (541) 682-3551
2073 Olympic St
Springfield, OR 97477
Phone (541) 682-3530
Interoperability endpoints
- https://api.platform.athenahealth.com/13337/brand/1/csg/1/fhir/r4
Organizations & group practices 6
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.
-
- Federally Qualified Health Center (FQHC)
- Springfield, OR
- NPI 1326138314
-
- Family Medicine Physician
- Albany, OR
- NPI 1740216498
-
- Durable Medical Equipment & Medical Supplies
- Corvallis, OR
- NPI 1477851186
-
- Urgent Care Clinic/Center
- Port Ludlow, WA
- NPI 1093969859
-
- Federally Qualified Health Center (FQHC)
- Kingston, WA
- NPI 1518585579
-
- Federally Qualified Health Center (FQHC)
- Kingston, WA
- NPI 1760428650
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705881600000",
"number": "1760435135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 SW 26TH ST",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973318624",
"telephone_number": "541-737-9355",
"fax_number": "541-737-9655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "850 SW 2TH STREET",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "97331",
"telephone_number": "541-737-9355",
"fax_number": "541-737-9665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TATHAM",
"first_name": "ELINOR",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-18",
"last_updated": "2024-01-22",
"certification_date": "2024-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD152758",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD00033246",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1095389",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
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 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; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.