CORVALLIS CLINIC PC (NPI# 1699921296) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699921296 |
| Entity Type | Organization |
| Organization Name | CORVALLIS CLINIC PC |
| Practice Address |
3680 Nw Samaritan Dr Corvallis OR 97330-3737 |
| Mailing Address |
444 Nw Elks Dr Corvallis OR 97330-3745 |
| Practice Telephone | 5417541150 |
| Mailing Telephone | 5417541150 |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2018-12-03 |
| Authorized Official Name | MR. EDWARD KELLY (CEO) |
| Authorized Official Telephone | 5417541374 |
| Is Organization Subpart | Y |
| Parent Organization Name | CORVALLIS CLINIC PC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | 38D0656873 | OR | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 276663 | 05 | |
| OR | 276697 | 05 | |
| OR | 299481 | 05 | |
| OR | 276671 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881850386 | Corvallis Clinic PC | Clinic/Center | 601 Nw Elks Drive, Corvallis, OR 97330-3781 | 2008-08-04 |
| 1730345596 | Corvallis Clinic PC | Clinic/Center | 444 Nw Elks Dr, Corvallis, OR 97330-3745 | 2008-07-31 |
| 1649227265 | Corvallis Clinic PC | Technician/Technologist | 444 Nw Elks Dr, Corvallis, OR 97330-3745 | 2006-05-28 |
| 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 |
| 1063961373 | Elisabeth Romatz Mahmud | Registered Nurse | 3680 Nw Samaritan Dr, Corvallis, OR 97330-3737 | 2016-09-27 |
| 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 |
| 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 | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053652594 | Willamette Valley Toxicology | Clinical Medical Laboratory | 545 Sw 2nd St, Suite 201, Corvallis, OR 97333-4466 | 2013-03-07 |
| 1659888097 | Quest Diagnostics Clinical Laboratories Inc | Clinical Medical Laboratory | 2400 Nw Kings Blvd, Corvallis, OR 97330-3900 | 2018-01-08 |
| 1568882454 | Ous Oregon State University | Clinical Medical Laboratory | 108 Sw Memorial Pl, Osu Student Health Services Laboratory, Corvallis, OR 97331-8667 | 2014-04-18 |
| 1023336914 | Sleep Management Group, LLC | Clinical Medical Laboratory | 2310 Nw Kings Blvd, Corvallis, OR 97330-3925 | 2010-05-17 |
| 1982933701 | Quest Diagnostics Clinical Laboratories Inc | Clinical Medical Laboratory | 1128 Ne 2nd St, Suite 3101, Corvallis, OR 97330-6230 | 2009-12-08 |
| 1831348671 | The Corvallis Clinic PC | Clinical Medical Laboratory | 3680 Nw Samaritan Dr, Corvallis, OR 97330-3737 | 2008-09-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649881483 | True Diagnostics | Clinical Medical Laboratory | 1122 Ne 122nd Ave Ste B-102, Portland, OR 97230-2081 | 2020-08-14 |
| 1497363543 | Laboratory Corporation of America | Clinical Medical Laboratory | 4212 Ne Broadway Rm L100, Portland, OR 97213-1422 | 2020-07-15 |
| 1245881721 | Laboratory Corporation of America | Clinical Medical Laboratory | 3896 Beverly Ave Ne Bldg J Ste 40, Salem, OR 97305-1374 | 2019-09-25 |
| 1215594270 | Emerald National Laboratory LLC | Clinical Medical Laboratory | 1710 Willow Creek Cir Ste 174, Eugene, OR 97402-9192 | 2019-05-24 |
| 1568927903 | Alerra, LLC | Clinical Medical Laboratory | 618 Nw 12th Ave Apt 412, Portland, OR 97209-3031 | 2019-02-08 |
| 1831664515 | A Worksafe Service, Inc. | Clinical Medical Laboratory | 1696 Capitol St Ne, Salem, OR 97301-7855 | 2018-10-09 |
| 1568980555 | Quest Diagnostics Clinical Laboratories Inc | Clinical Medical Laboratory | 217 Division Ave Ste A, Eugene, OR 97404-5429 | 2017-08-30 |
| 1861937237 | Malachai Investments LLC | Clinical Medical Laboratory | 10,000 Se Main St, Ste 360, Portland, OR 97216 | 2016-12-21 |
| 1255703245 | Guidant Toxicology LLC | Clinical Medical Laboratory | 3329 Wintercreek Ct, Eugene, OR 97405-6238 | 2015-10-29 |
| 1275905473 | Precision Laboratories LLC | Clinical Medical Laboratory | 1720 Willow Creek Cir, Suite 525 B, Eugene, OR 97402-9171 | 2015-10-27 |
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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.