Active NPI
Tessa Rhea Maggiulli, DVM
- General Practice Physician
- Corvallis, OR
National Provider Identifier
1780280792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 7121
- Practice address
- 1562 SW 3Rd St
Corvallis, OR 97333-1240 - Phone
- (541) 753-2223
- Fax
- (541) 753-2278
- NPI assigned
- Dec 7, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 7121 | OR | Primary |
Addresses
Primary practice location
1562 SW 3Rd St
Corvallis, OR 97333-1240
Mailing address
1562 SW 3Rd St
Corvallis, OR 97333-1240
Phone (541) 753-2223
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7121 | OR | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607299200000",
"number": "1780280792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1562 SW 3RD ST",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973331240",
"telephone_number": "541-753-2223",
"fax_number": "541-753-2278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1562 SW 3RD ST",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973331240",
"telephone_number": "541-753-2223",
"fax_number": "541-753-2278"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAGGIULLI",
"first_name": "TESSA",
"middle_name": "RHEA",
"name_prefix": "Dr.",
"credential": "DVM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-07",
"last_updated": "2020-12-07",
"certification_date": "2020-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "OR",
"license": "7121",
"primary": true
}
],
"identifiers": [],
"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 Dec 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.