NPIMap

Organization Active NPI

Good Samaritan Hospital Corvallis

  • Internal Medicine Physician
  • Corvallis, OR
National Provider Identifier
1790041549
Registry record updated Nov 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
GOOD SAMARITAN HOSPITAL CORVALLIS
Practice address
5234 Philomath Blvd.
Suite B
Corvallis, OR 97330-3767
Phone
(541) 768-6211
Fax
(541) 768-9385
NPI assigned
Apr 5, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2018

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

Authorized official

Name
Becky Pape
Title
Ceo
Phone
(541) 768-5009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

5234 Philomath Blvd.
Suite B
Corvallis, OR 97330-3767

Mailing address

5234 SW Philomath Blvd Ste B
Corvallis, OR 97333-1042
Phone (541) 768-6211

Other identifiers 1

IdentifierTypeStateIssuer
500651540MedicaidOR

Other names 1

  • Samaritan Occupational Medicine - Corvallis Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031125000163 OR Part B Supplier - Clinic/Group Practice 1557270725 Receives reassigned benefits from 589 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Corvallis, OR; Albany, OR

National Provider Directory

National Provider Directory

Practitioners 12

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

NPI Registry JSON

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

{
    "created_epoch": "1333584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541635200000",
    "number": "1790041549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5234 SW PHILOMATH BLVD STE B",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973331042",
            "telephone_number": "541-768-6211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5234 PHILOMATH BLVD.",
            "address_2": "SUITE B",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303767",
            "telephone_number": "541-768-6211",
            "fax_number": "541-768-9385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN HOSPITAL CORVALLIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-05",
        "last_updated": "2018-11-08",
        "status": "A",
        "authorized_official_last_name": "PAPE",
        "authorized_official_first_name": "BECKY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-768-5009"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500651540",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Samaritan Occupational Medicine - Corvallis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.