ELISABETH ROMATZ MAHMUD (NPI# 1063961373) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063961373 |
| Entity Type | Individual |
| Full Name | ELISABETH ROMATZ MAHMUD |
| Credential | RN, AGNP |
| Practice Address |
3680 Nw Samaritan Dr Corvallis OR 97330-3737 |
| Mailing Address |
444 Nw Elks Drive Corvallis OR 97330 |
| Practice Telephone | 5417541150 |
| Mailing Telephone | (541) 754-1150 |
| Enumeration Date | 2016-09-27 |
| Last Update Date | 2017-11-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WG0600X |
Registered Nurse Specialization: Gerontology |
NC60406565 | WA | Nursing Service Providers |
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
201701726NP-PP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
AP60689189 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3680 NW SAMARITAN DR |
| City | CORVALLIS |
| State | OR |
| Zip Code | 97330-3737 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508852252 | Patricia Shannon Hopson | Internal Medicine | 3680 Nw Samaritan Dr, Corvallis, OR 97330 | 2005-09-27 |
| 1568007649 | Miriam Geneva Powell | Specialist/Technologist, Other | 3680 Nw Samaritan Dr, Corvallis, OR 97330-3737 | 2019-11-12 |
| 1043853948 | Elise Noel Bascom | Psychologist | 3680 Nw Samaritan Dr, Corvallis, OR 97330-3737 | 2019-10-23 |
| 1881252252 | Jennifer Marie Giles | Surgery | 3680 Nw Samaritan Dr, Corvallis, OR 97330-3737 | 2019-05-31 |
| 1316503774 | Naomi Elizabeth Shantz | Nurse Practitioner | 3680 Nw Samaritan Dr, Corvallis, OR 97330 | 2019-05-11 |
| 1134613110 | Maddison Marie Greaves | Dietitian, Registered | 3680 Nw Samaritan Dr, Corvallis, OR 97330-3737 | 2018-06-21 |
| 1831631522 | Joshua Bergh | Physician Assistant | 3680 Nw Samaritan Dr, Corvallis, OR 97330-3737 | 2016-11-10 |
| 1689127045 | Nicolette Rosendahl | Neuromusculoskeletal Medicine & OMM | 3680 Nw Samaritan Dr, Corvallis, OR 97330-3737 | 2016-08-02 |
| 1003271727 | Laura Luczkiw | Dietitian, Registered | 3680 Nw Samaritan Dr, Corvallis, OR 97330-3737 | 2015-12-22 |
| 1114392842 | Krista Dae Stieglitz | Registered Nurse | 3680 Nw Samaritan Dr, Corvallis, OR 97330-3737 | 2015-12-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235754912 | Miya Claborn | Counselor | 4495 Se Hwy 20, Corvallis, OR 97330 | 2020-06-09 |
| 1548889017 | Greydi Olvera | Counselor | Childrens Farm Home 4455 Ne Hwy 20, Corvallius, OR 97330 | 2020-04-14 |
| 1053953992 | Andie Marie Gaipo | Counselor | 4455 Ne Hwy 20 - Children's Farm Home, Corvallis, OR 97330 | 2019-10-11 |
| 1740847177 | Stephen Jack Eccles | Behavior Technician | Trillium Children's Farm Home, 4455 Ne Hwy 20, Corvallis, OR 97330 | 2019-05-21 |
| 1750944815 | Tiffany Rene Flinchpaugh | Counselor | Children's Farm Home 4455 Hwy 20, Corvallis, OR 97330 | 2019-04-15 |
| 1679035455 | Isaiah Mile Cassidy | Counselor | Children's Farm Home-4455 Ne Hwy 20, Corvallis, OR 97330 | 2019-04-02 |
| 1982168399 | Haylee Cramblit | Counselor | Children's Farm Home 4455 Ne Hwy 20, Corvallis, OR 97330 | 2019-01-30 |
| 1457835365 | Ashley Alyn Couch | Counselor | 4455 Hwy 20 Corvallis 97330, Corvallis, OR 97330 | 2018-09-18 |
| 1104318898 | Megan Gerding | Technician, Other | 996 Nw Circle Blvd Suite 103, Corvallis, OR 97330 | 2018-05-30 |
| 1700377108 | Pacific Hearing Services | Audiologist | 975 Nw Spruce Ave, Suite #101, Corvallis, OR 97330 | 2018-05-22 |
| Find all providers in zip 97330 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558383430 | Nancy A Erb | Nurse Practitioner | 16209 W Hoffeldt Ln, Suite B, Brookings, OR 97415-9470 | 2006-07-23 |
| 1124058789 | Elizabeth Vonwellsheim | Nurse Practitioner | 382b South 58th Street, Springfield, OR 97478 | 2006-07-03 |
| 1568419091 | Carolyn Dolores Concia | Nurse Practitioner | 2308 Nw Stimpson Ln, Portland, OR 97229-8562 | 2006-05-30 |
| 1417581315 | Well Spring Health LLC | Nurse Practitioner | 835 Crater Lake Ave, Medford, OR 97504-6505 | 2020-02-28 |
| 1821647173 | Haley Grace Ruljancich | Nurse Practitioner | 4010 Aerial Way, Eugene, OR 97402-9757 | 2019-09-10 |
| 1043862550 | Katherine Felicia Edstrom | Nurse Practitioner | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2019-07-15 |
| 1487216669 | Carolyn D Concia Np Prof Corp | Nurse Practitioner | 2308 Nw Stimpson Ln, Portland, OR 97229-8562 | 2019-07-08 |
| 1811550866 | Elisa Denise Garrett | Nurse Practitioner | 675 N 5th St, Lebanon, OR 97355-2875 | 2019-04-16 |
| 1255800850 | Peter Woodring | Nurse Practitioner | 610 Hawthorne Ave Se Ste 110, Salem, OR 97301-5378 | 2018-11-13 |
| 1154809903 | Molly Christine Davis | Nurse Practitioner | 4805 Ne Glisan St Ste 11n, Portland, OR 97213-2933 | 2018-08-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.