CORVALLIS MEDICAL GROUP, LLC (NPI# 1740668649) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740668649 |
| Entity Type | Organization |
| Organization Name | CORVALLIS MEDICAL GROUP, LLC |
| Practice Address |
545 Sw 2nd St Suite 200 Corvallis OR 97333-4466 |
| Practice Telephone | 5412864742 |
| Practice Fax Number | 5412018633 |
| Mailing Telephone | 5412864742 |
| Mailing Fax Number | 5412018633 |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2015-05-11 |
| Authorized Official Name | DR. PATRICK RASK (PHYSICIAN/OWNER) |
| Authorized Official Telephone | 5412864742 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
MD20927 | OR | Allopathic & Osteopathic Physicians |
| Street Address |
545 SW 2ND ST SUITE 200 |
| City | CORVALLIS |
| State | OR |
| Zip Code | 97333-4466 |
| 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 |
| 1164829412 | Nw Surgical Center | Clinic/Center | 545 Sw 2nd St, Corvallis, OR 97333-4466 | 2014-12-02 |
| 1891191672 | Jarod Smith | Nurse Practitioner | 545 Sw 2nd St, Suite 200, Corvallis, OR 97333-4466 | 2014-11-06 |
| 1801210802 | Nw Surgical Center LLC | Clinic/Center | 545 Sw 2nd St, Corvallis, OR 97333-4466 | 2014-02-11 |
| 1053744524 | Christopher Jason Smith | Pain Medicine | 545 Sw 2nd St, Ste 200, Corvallis, OR 97333-4466 | 2013-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437629037 | Collin Korthauer | Case Manager/Care Coordinator | 1650 Sw 45th Place, Corvallis, OR 97333 | 2018-11-27 |
| 1477079937 | Adam Johnson | Counselor | 518 Sw 3rd, Corvallis, OR 97333 | 2017-08-16 |
| 1386961522 | Michael S. Hanson | Counselor | 518 Sw 3rd St., Corvallis, OR 97333 | 2010-04-28 |
| 1134392376 | Corvallis Physical Therapy Inc | Physical Therapist | 230 Sw 3rd Street Suite 208, Corvallis, OR 97333 | 2008-04-09 |
| 1154529600 | Linda S Lavallee Conniff | Social Worker | 216 Sw Madison Av, #9 10, Corvallis, OR 97333 | 2007-07-06 |
| 1235337056 | Robert R Conniff | Social Worker | 216 Sw Madison Ave, 2, Corvallis, OR 97333 | 2007-07-03 |
| 1619178829 | Trillium Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 4455 Highway North West Highway 20, Corvallis, OR 97333 | 2007-05-29 |
| 1437368867 | Margaret Anne Cooper | Physical Therapist | 230 Sw 3rd Street, Suite 208, Corvallis, OR 97333 | 2007-05-22 |
| 1801009311 | Madeline Elizabeth Rubin | Social Worker | 216 Sw Madison Avenue, Suite 14, Corvallis, OR 97333 | 2007-05-08 |
| 1780707174 | Wheeler John Dale | Internal Medicine | 5060 Sw Philomath Blvd, # 512, Corvallis, OR 97333 | 2007-04-09 |
| Find all providers in zip 97333 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164942611 | Mid-valley Healthcare, Inc. | Pain Medicine | 5234 Sw Philomath Blvd Ste C, Corvallis, OR 97333-1042 | 2017-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093269995 | Center for Regenerative Orthopedic Medicine, PC | Pain Medicine | 786 State St, Medford, OR 97504-8441 | 2016-08-09 |
| 1649420548 | Pacific Pain Management PC | Pain Medicine | 6542 Se Lake Rd Ste 202, Milwaukie, OR 97222-2245 | 2008-09-26 |
| 1336265107 | Laura M Scobie | Pain Medicine | 1010 Tenth St, Hood River, OR 97031 | 2007-03-22 |
| 1427188309 | Patrick Rask | Pain Medicine | 2364 Main St, Suite A, Philomath, OR 97370-9488 | 2007-03-07 |
| 1831125616 | Joseph S Dunn | Pain Medicine | 74b Centennial Loop Ste 100, Eugene, OR 97401-7919 | 2006-06-24 |
| 1912940396 | Mid-valley Healthcare Inc | Pain Medicine | 100 Mullins Dr Ste C, Lebanon, OR 97355-3982 | 2006-06-14 |
| 1063418333 | Vladimir B. Fiks | Pain Medicine | 10305 Sw Park Way, Ste 300, Portland, OR 97225-5033 | 2005-06-22 |
| 1881186336 | Pacific Sports and Interventional Spine, LLC | Pain Medicine | 74b Centennial Loop Ste 100, Eugene, OR 97401-7919 | 2018-05-31 |
| 1861900516 | Cornell Pain Clinic LLC | Pain Medicine | 15455 Nw Greenbrier Pkwy Ste 130, Beaverton, OR 97006 | 2018-01-16 |
| 1578077954 | Liberty Spine & Pain Center, P.C. | Pain Medicine | 350 Miller St Se, Salem, OR 97302-4272 | 2017-11-21 |
| Find all providers with the same taxonomy | ||||
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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.