PROVIDENCE HEALTH & SERVICES - OREGON (NPI# 1417978164) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417978164 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES - OREGON |
| Other Organization Name | PROVIDENCE BENEDICTINE NURSING CENTER |
| Practice Address |
540 S Main St Mount Angel OR 97362-9540 |
| Practice Telephone | 5038456841 |
| Practice Fax Number | 5038459229 |
| Mailing Telephone | 5038456841 |
| Mailing Fax Number | 5038459229 |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2020-07-02 |
| Authorized Official Name | DONALD W ANDERSON JR. (ASST SEC FOR ENROLL/DIR REIMB ADMIN) |
| Authorized Official Telephone | 4255255392 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 313M00000X | Nursing Facility/Intermediate Care Facility | 385018 | OR | Nursing & Custodial Care Facilities |
| Y | 314000000X | Skilled Nursing Facility | 385018 | OR | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 800006 | 05 |
| Other Name | Type Code |
|---|---|
| Providence Benedictine Nursing Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922481456 | Providence Health & Services - Oregon | Psychiatry & Neurology | 10830 Highway 62, Eagle Point, OR 97524-9516 | 2015-07-01 |
| 1023440435 | Providence Health & Services - Oregon | General Acute Care Hospital | 11445 Se Moon Dust Ct, Happy Valley, OR 97086-8033 | 2013-08-08 |
| 1568793313 | Providence Health & Services - Oregon | Clinic/Center | 17550 Provost St Ste 201, Lake Oswego, OR 97034-5199 | 2010-01-19 |
| 1508015348 | Providence Health & Services - Oregon | Clinic/Center | 16180 Se Sunnyside Road, Suite 102, Happy Valley, OR 97015-6302 | 2008-09-17 |
| 1114085545 | Providence Health & Services - Oregon | Internal Medicine | 1314 E Sherman St, Newberg, OR 97132-1842 | 2006-12-05 |
| 1629146121 | Providence Health & Services - Oregon | Otolaryngology | 310 Villa Rd, Suite 104, Newberg, OR 97132-1886 | 2006-12-01 |
| 1992882500 | Providence Health & Services - Oregon | Clinic/Center | 205 N Phoenix Rd, Suite A, Phoenix, OR 97535-9104 | 2006-11-01 |
| 1013018175 | Providence Health & Services - Oregon | Clinic/Center | 510 Bridge St, Vernonia, OR 97064-1218 | 2006-09-25 |
| 1447799523 | Providence Health & Services - Oregon | Clinic/Center | 1698 E Mcandrews Rd Ste 170, Medford, OR 97504-5590 | 2017-02-22 |
| 1063963106 | Providence Health & Services - Oregon | Clinic/Center | 1698 E Mcandrews Rd, Ste 300, Medford, OR 97504-5589 | 2016-10-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Providence Health & Services - Oregon | 1801 Lind Avenue, Sw, Renton, WA 98057-9016 |
| Oregon Corporations, Companies and Business Names | PROVIDENCE HEALTH & SERVICES - OREGON | 1801 Lind Ave Sw #9016, Renton, WA 98057 |
| System for Award Management (SAM) Entities | PROVIDENCE HEALTH & SERVICES - OREGON | 4400 Ne Halsey St Bldg 2 Ste 690, Portland, OR 97213-1545 |
| Iowa Business Entities | PROVIDENCE HEALTH & SERVICES - OREGON | 1801 Lind Ave. Sw, Renton, WA 98057 |
| Washington State Corporations | PROVIDENCE HEALTH & SERVICES - OREGON | 1801 Lind Ave Sw # 9016, Renton, WA 98057 |
| Street Address |
540 S MAIN ST |
| City | MOUNT ANGEL |
| State | OR |
| Zip Code | 97362-9540 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669030508 | Sheila Helen Houle | Occupational Therapist | 540 S Main St, Mount Angel, OR 97362-9540 | 2019-06-05 |
| 1487210779 | Katherine Allyn Sprauer | Occupational Therapist | 540 S Main St, Mount Angel, OR 97362-9540 | 2019-05-13 |
| 1114492642 | Amy Van Goey | Occupational Therapist | 540 S Main St, Mount Angel, OR 97362-9540 | 2018-10-11 |
| 1962982157 | Anna Mchugh | Occupational Therapist | 540 S Main St, Mount Angel, OR 97362-9540 | 2018-08-16 |
| 1013438415 | Stefanie Marie Mack | Case Manager/Care Coordinator | 540 S Main St, Mount Angel, OR 97362-9540 | 2017-07-06 |
| 1770037939 | Merissa Zielinski | Speech-Language Pathologist | 540 S Main St, Mount Angel, OR 97362-9540 | 2016-08-05 |
| 1891168548 | Amanda Contreras | Occupational Therapist | 540 S Main St, Mount Angel, OR 97362-9540 | 2015-11-03 |
| 1710393293 | Leah Kresse | Occupational Therapist | 540 S Main St, Mount Angel, OR 97362-9540 | 2014-07-07 |
| 1780099986 | April Haney | Counselor | 540 S Main St, Mount Angel, OR 97362-9540 | 2014-06-25 |
| 1598179475 | Clara Heinz | Occupational Therapist | 540 S Main St, Mount Angel, OR 97362-9540 | 2014-06-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912321308 | Michael John Petracci | Chiropractor | 690 N Main St, Mount Angel, OR 97362 | 2014-02-06 |
| 1215230651 | Jess Ransom Miller | Family Medicine | 250 W Marquam St, Mount Angel, OR 97362 | 2010-12-07 |
| 1669691721 | Heidi Margarita Abreu Pacheco | Internal Medicine | 250 W Marquam St, Mount Angel, OR 97362 | 2007-04-25 |
| 1750630695 | Amy Roth | Occupational Therapist | 540 S. Main St, Mt. Angel, OR 97362-0000 | 2012-09-06 |
| 1356989271 | Brittany Micaela Curths | Behavior Technician | 315 S Pershing St, Mount Angel, OR 97362-9508 | 2019-12-11 |
| 1942268354 | Faith L. Koschmann | Family Medicine | 690 N Main St, Mount Angel, OR 97362-9518 | 2006-05-03 |
| 1760801310 | Foundations Health and Wellness Center LLC | Chiropractor | 690 N Main St, Mount Angel, OR 97362-9518 | 2014-04-10 |
| 1972644250 | Charles D Hyde | Nurse Practitioner | 690 N Main St, Mount Angel, OR 97362-9518 | 2007-02-09 |
| 1437107083 | James Edward Domst | Family Medicine | 690 N Main St, Mount Angel, OR 97362-9518 | 2006-05-05 |
| 1962450551 | Mayda Ramos | Internal Medicine | 690 N Main St, Mount Angel, OR 97362-9518 | 2006-05-05 |
| Find all providers in zip 97362 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518565035 | Bkd Hillside Opco, LLC | Skilled Nursing Facility | 440 Nw Hillside Park Way, Mcminnville, OR 97128 | 2020-10-16 |
| 1689231383 | Marquis Companies I Inc | Skilled Nursing Facility | 410 Se Church Street, Sublimity, OR 97385 | 2019-05-29 |
| 1720528003 | Rashelle M Johnson | Skilled Nursing Facility | 2457 Ne Bobbi Pl, Prineville, OR 97754-9089 | 2017-03-06 |
| 1881133254 | Jessie Steele | Skilled Nursing Facility | 2693 Nw Crossing Dr, Bend, OR 97703-7347 | 2017-02-18 |
| 1063969988 | Set Op Co | Skilled Nursing Facility | 1220 20th St Se, 310, Salem, OR 97302-1205 | 2016-09-08 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| 1710336672 | Lauren Biamont | Skilled Nursing Facility | 5748 Smoketree Dr Se, Salem, OR 97306-1260 | 2016-06-10 |
| 1801278049 | Darrel A Decker | Skilled Nursing Facility | 350 8th Street, Lebanon, OR 97355 | 2015-06-24 |
| 1508250762 | West Linn Care Ctr Operating Co, LLC | Skilled Nursing Facility | 2330 Deok Rd., West Linn, OR 97068-3902 | 2015-03-26 |
| 1568871770 | Keizer River Operations, LLC | Skilled Nursing Facility | 450 Clagett Ct. N, Keizer, OR 97303-4400 | 2014-08-13 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT ANGEL |
| Zip Code | 97362 |
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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.