Regency @ Corvallis, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

REGENCY @ CORVALLIS, LLC

Doing business as

Regency Park Place @ Corvallis

Practice address

2595 NE Jack London St
Corvallis, OR 97330-6915

Phone

(541) 754-5808

NPI assigned

Apr 23, 2009

Organization subpart

No

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

Authorized official

Name

Doug Devore

Title

Cfo

Phone

(425) 392-4066

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Regency Park Place @ Corvallis Doing business as

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

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

{
    "created_epoch": "1240444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240444800000",
    "number": "1821232687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2595 NE JACK LONDON ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973306915",
            "telephone_number": "541-754-5808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2595 NE JACK LONDON ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973306915",
            "telephone_number": "541-754-5808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENCY @ CORVALLIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-23",
        "last_updated": "2009-04-23",
        "status": "A",
        "authorized_official_last_name": "DEVORE",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "425-392-4066"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE",
            "identifier": "1659522651",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regency Park Place @ Corvallis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Charles William Reel
• Gabrielle Marie Reel
• Ryan Matthew O'Neal Reeser, DO
• Kristen Henry Reeve, PA-C
• William Barry Reeves, M.D.
• Rehabilitation Associates Northwest
• Aaron Reher
• Kristi Reher, M.COUN
• Jeremy Belden Rehn, DPT
• Linda H. Reid, RN

• Assisted Living Facility in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Assisted Living Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.