NPIMap

Organization Active NPI

Corvallis Clinic PC

Doing business as Corvallis Clinic Walnut CME only

  • Durable Medical Equipment & Medical Supplies
  • Corvallis, OR
National Provider Identifier
1881468593
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
CORVALLIS CLINIC PC
Doing business as
Corvallis Clinic Walnut CME only
Practice address
2350 NW Century Dr Ste 100
Corvallis, OR 97330-3495
Phone
(541) 754-1265
NPI assigned
Nov 13, 2023
Last updated
Jan 25, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
CORVALLIS CLINIC PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Authorized official

Name
Mr. James Kaech
Title
Chief Executive Officer
Phone
(541) 754-1374

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

2350 NW Century Dr Ste 100
Corvallis, OR 97330-3495

Mailing address

444 NW Elks Dr
Corvallis, OR 97330-3745
Phone (541) 754-1374

Other names 1

  • Corvallis Clinic Walnut CME only Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D0894793Corvallis Clinic Occupational Medicine, the2350 NW Century Drive, Suite 100, Corvallis, OR 97330Certificate of waiverDec 31, 2027

National Provider Directory

National Provider Directory
Tax ID family
Corvallis Clinic18 organizations share this tax ID, including this one
Part of
Corvallis Clinic

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1699833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706140800000",
    "number": "1881468593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 NW ELKS DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303745",
            "telephone_number": "541-754-1374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 NW CENTURY DR STE 100",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303495",
            "telephone_number": "541-754-1265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORVALLIS CLINIC PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CORVALLIS CLINIC PC",
        "enumeration_date": "2023-11-13",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A",
        "authorized_official_last_name": "KAECH",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "541-754-1374",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corvallis Clinic Walnut CME only",
            "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 Jan 25, 2024; 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.