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CORVALLIS CLINIC PHYSICAL THERAPY HERITAGE MALL DME ONLY
NPI 1093589798
Durable Medical Equipment & Medical Supplies in Albany, OR

Active since November 13, 2023CLIA Certified · 3 labs
1815 14TH AVE SE, ALBANY, OR 97322(541) 754-1265 Get Directions Write a Review

NPPES record last updated: January 25, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Corvallis Clinic Physical Therapy Heritage Mall Dme Only NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CORVALLIS CLINIC PHYSICAL THERAPY HERITAGE MALL DME ONLY (NPI 1093589798) is a healthcare organization registered as a durable medical equipment & medical supplies in Albany, Oregon and active in the NPI registry since November 2023. The organization holds 3 active CLIA laboratory certificates and lists James Kaech, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1093589798
Entity TypeOrganization
Primary Taxonomy332B00000X
Legal Business NameCORVALLIS CLINIC PC
Location Address1815 14TH AVE SEAlbany, OR 97322-8502
Mailing Address444 Nw Elks DrCorvallis, OR 97330-3745 · (541) 754-1374
Phone(541) 754-1265
Organization SubpartYes
Authorized OfficialJames KaechChief Executive Officer · (541) 754-1374
Enumeration DateNovember 13, 2023
Last NPPES UpdateJanuary 25, 2024
NPPES CertifiedJanuary 25, 2024
✔ NPI 1093589798 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers
Taxonomy Code332B00000X
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
1815 14TH AVE SE, Albany, OR 97322
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Other Names 1

Doing Business AsCorvallis Clinic Physical Therapy Heritage Mall Dme Only

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 38D2345002

Corvallis Clinic Occupational Medicine At Waverly · Albany, OR
Active · expires Jun 2, 2028
CLIA Number38D2345002
Laboratory TypePhysician Office
Certificate Effective DateJune 3, 2026
Certificate Expiration DateJune 2, 2028
Laboratory DirectorRobert Tyler Cocoran
Laboratory Phone(541) 967-8221
Laboratory LocationCorvallis Clinic Occupational Medicine At Waverly1705 Waverly Drive SE, Albany, OR 97322
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 38D0894793

Corvallis Clinic Occupational Medicine, The · Corvallis, OR
Active · expires Dec 31, 2027
CLIA Number38D0894793
Laboratory TypePhysician Office
Certificate Effective DateJanuary 1, 2026
Certificate Expiration DateDecember 31, 2027
Laboratory DirectorRobert Tyler Corcoran
Laboratory Phone(541) 753-1786
Laboratory LocationCorvallis Clinic Occupational Medicine, The2350 NW Century Drive, Suite 100, Corvallis, OR 97330
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 38D1060111

Corvallis Clinic Surgery Center,the · Corvallis, OR
Active · expires Oct 15, 2026
CLIA Number38D1060111
Laboratory TypePhysician Office
Certificate Effective DateOctober 16, 2024
Certificate Expiration DateOctober 15, 2026
Laboratory DirectorRobert Tyler Corcoran
Laboratory Phone(541) 754-1254
Laboratory LocationCorvallis Clinic Surgery Center,the601 NW Elks Drive, Corvallis, OR 97330
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. AIMEE L HAVENS DPT
Physical Therapist
1815 14TH AVE SE
ALBANY, OR 97322
Linn County (541) 754-1265
KRISTY LYNN KIRONDE FNP
Nurse Practitioner (Family)
1815 14TH AVE SE
ALBANY, OR 97322
Linn County (541) 754-1369
LESLIE ANN SHORTRIDGE F.N.P
Nurse Practitioner (Family)
1815 14TH AVE SE
ALBANY, OR 97322
Linn County (541) 547-1369
THOMAS M SEASTONE DPT
Physical Therapist
1815 14TH AVE SE
ALBANY, OR 97322
Linn County (541) 754-1265

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Corvallis Clinic PC's NPI number?

The NPI number for Corvallis Clinic PC is 1093589798. It was assigned to this organization in the NPPES registry on November 13, 2023. The provider is doing business as Corvallis Clinic Physical Therapy Heritage Mall Dme Only.

Where is Corvallis Clinic PC located?

Corvallis Clinic PC is located at 1815 14th Ave SE, Albany, OR 97322. The listed phone number is (541) 754-1265.

What is Corvallis Clinic PC's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

Does Corvallis Clinic PC hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Corvallis Clinic PC was last updated on January 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.