MICHELLE RENAE-PIPPEL KELLER (NPI# 1154763050) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154763050 |
| Entity Type | Individual |
| Full Name | MICHELLE RENAE-PIPPEL KELLER |
| Other Name | MICHELLE RENAE-PIPPEL JOHNSTON |
| Credential | PA-C |
| Practice Address |
3615 Nw Samaritan Dr Suite 210 Corvallis OR 97330-3783 |
| Practice Telephone | 5417684501 |
| Practice Fax Number | 5417685211 |
| Mailing Telephone | 5417684501 |
| Mailing Fax Number | 5417685211 |
| Enumeration Date | 2013-07-22 |
| Last Update Date | 2016-02-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE PTAN (INDIVIDUAL) | F400173350 | 01 |
| IL | MEDICARE PTAN (GROUP) | 206147 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194351809 | Michelle Lynn Keller | Counselor | 12701 Townepark Way Bldg Suite200, Louisville, KY 40243-2384 | 2020-03-14 |
| 1003323809 | Michelle Lea Keller | Social Worker | 3710 Sw Us Veterans Hospital Rd, Portland, OR 97239-2964 | 2018-01-03 |
| 1871022285 | Michelle Keller | Community Health Worker | 4989 North 3rd Street, Laramie, WY 82072-9548 | 2017-06-08 |
| 1295273852 | Michelle Marie Keller | Counselor | 3317 W 95th St, Evergreen Park, IL 60805-2243 | 2017-02-03 |
| 1053724369 | Michelle Lynn Powell Keller | Behavioral Analyst | 3500 Sw 10th Ave, Topeka, KS 66604-1904 | 2014-06-04 |
| 1609040765 | Michelle Lea Keller | Physical Therapist | 300 N 7th St, Bismarck, ND 58501-4439 | 2008-04-18 |
| 1073656807 | Michelle Marie Keller | Social Worker | 7441 O St Ste 402, Lincoln, NE 68510-2466 | 2007-02-14 |
| Street Address |
3615 NW SAMARITAN DR SUITE 210 |
| City | CORVALLIS |
| State | OR |
| Zip Code | 97330-3783 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316944572 | Anthony Charlies De Mory | Internal Medicine | 3615 Nw Samaritan Dr, Suite 203, Corvallis, OR 97330-3783 | 2005-07-02 |
| 1063771152 | Good Samaritan Hospital Corvallis | Neurological Surgery | 3615 Nw Samaritan Dr, Suite 211, Corvallis, OR 97330-3783 | 2012-05-09 |
| 1144596479 | Good Samaritan Hospital Corvallis | Surgery | 3615 Nw Samaritan Dr, Suite 201, Corvallis, OR 97330-3783 | 2012-03-30 |
| 1528395969 | Crystal M Buglino | Physician Assistant | 3615 Nw Samaritan Dr, Suite 201, Corvallis, OR 97330-3783 | 2009-11-05 |
| 1073749396 | Poojitha Reddy Beravol | Internal Medicine | 3615 Nw Samaritan Dr, Suite 203, Corvallis, OR 97330-3783 | 2009-06-01 |
| 1801914734 | Ida B. Skinner | Clinical Nurse Specialist | 3615 Nw Samaritan Dr, Suite 201, Corvallis, OR 97330-3783 | 2007-03-27 |
| 1306976022 | Frank Clifford Roberson | Neurological Surgery | 3615 Nw Samaritan Dr, Suite 210, Corvallis, OR 97330-3783 | 2007-03-06 |
| 1942343025 | Jacqueline D Joss | Pharmacist | 3615 Nw Samaritan Dr, Suite 103, Corvallis, OR 97330-3783 | 2007-02-15 |
| 1326148552 | Christopher Michael Weinman | Physician Assistant | 3615 Nw Samaritan Dr, Suite 210, Corvallis, OR 97330-3783 | 2006-09-25 |
| 1477599058 | Steven K. Goodwin | Neurological Surgery | 3615 Nw Samaritan Dr, Suite 211, Corvallis, OR 97330-3783 | 2006-06-21 |
| 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 | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528395969 | Crystal M Buglino | Physician Assistant | 3615 Nw Samaritan Dr, Suite 201, Corvallis, OR 97330-3783 | 2009-11-05 |
| 1457685372 | Anca Stefania Kovacs | Physician Assistant | 2298 Nw Kings Blvd, Corvallis, OR 97330-3923 | 2009-09-24 |
| 1992936066 | Benjamin P Wallace | Physician Assistant | 3600 Nw Samaritan Drive, Suite 227, Corvallis, OR 97330-3737 | 2009-08-06 |
| 1497925135 | Scott G Sims | Physician Assistant | 3600 Nw Samaritan Dr, Suite 227, Corvallis, OR 97330-3737 | 2008-03-10 |
| 1043365513 | Douglas Duane Huntley | Physician Assistant | 3640 Nw Samaritan Dr, Corvallis, OR 97330-3784 | 2007-01-24 |
| 1447313010 | Tiara F Packer | Physician Assistant | 3620 Nw Samaritan Drive, Suite 202, Corvallis, OR 97330 | 2006-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619575008 | Janna Marie Check | Physician Assistant | 3555 Chad Drive, Eugene, OR 97408 | 2020-10-16 |
| 1922588508 | Melanie Grace Mix | Physician Assistant | 501 N Graham St Ste 420, Portland, OR 97227 | 2018-08-14 |
| 1396250122 | Saron Theresa Sufuentes | Physician Assistant | 578 Nw Marlborough Ave, Portland, OR 97210-3104 | 2017-12-01 |
| 1801321039 | Devin Fleming | Physician Assistant | 22936 Ne Pike St, Troutdale, OR 97060-2615 | 2017-04-25 |
| 1710435011 | Alexander Andersen | Physician Assistant | 445 Harlow Rd Ste 200, Springfield, OR 97477-1341 | 2016-09-14 |
| 1952775520 | Lauren Govier | Physician Assistant | 501 N Graham St Ste 415, Portland, OR 97227-2006 | 2015-11-19 |
| 1619346368 | Ryan Mcmahon | Physician Assistant | 3415 Ne 20th Ave, Portland, OR 97212-2416 | 2015-09-23 |
| 1518366863 | Latoya Allen | Physician Assistant | 2450 Highgate St, Unit 12, Medford, OR 97501-7955 | 2014-08-21 |
| 1528499910 | Elan Kennedy | Physician Assistant | 3181 Sw Sam Jackson Park Rd., Mail Code L353, Ohsu, Division of Cardiothoracic Surgery, Portland, OR 97239 | 2013-12-10 |
| 1699114421 | Lauren M Kendall | Physician Assistant | 960 N 16th St Ste 108, Springfield, OR 97477-4175 | 2013-06-14 |
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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.