NPIMap

Organization Active NPI

Corvallis MRI a Joint Venture

Doing business as Corvallis MRI

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Corvallis, OR
National Provider Identifier
1952529620
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X
Legal business name
CORVALLIS MRI A JOINT VENTURE
Doing business as
Corvallis MRI
Practice address
3615 NW Samaritan Drive
Suite 101
Corvallis, OR 97330-3737
Phone
(541) 768-5187
Fax
(541) 768-5092
NPI assigned
Apr 20, 2007
Last updated
Apr 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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

Authorized official

Name
Josiah Johnson
Title
Ceo - Gsrmc
Phone
(541) 768-5009

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X NU Primary
Magnetic Resonance Imaging Radiologic Technologist 2471M1202X NU

Addresses

Primary practice location

3615 NW Samaritan Drive
Suite 101
Corvallis, OR 97330-3737

Mailing address

3600 NW Samaritan Dr
Corvallis, OR 97330-5472
Phone (541) 768-5187

Other identifiers 1

IdentifierTypeStateIssuer
214502MedicaidOR

Other names 1

  • Corvallis MRI Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090730000430 OR Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 8628066925 Practice locations: Corvallis, OR

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

3615 NW Samaritan Dr
Corvallis, OR 97330
Phone (503) 757-5151

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775520000000",
    "number": "1952529620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 NW SAMARITAN DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973305472",
            "telephone_number": "541-768-5187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3615 NW SAMARITAN DRIVE",
            "address_2": "SUITE 101",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303737",
            "telephone_number": "541-768-5187",
            "fax_number": "541-768-5092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORVALLIS MRI A JOINT VENTURE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JOSIAH",
        "authorized_official_title_or_position": "CEO - GSRMC",
        "authorized_official_telephone_number": "541-768-5009"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2471M1202X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Magnetic Resonance Imaging",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "214502",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corvallis MRI",
            "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 Apr 7, 2026; 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.