PEACEHEALTH (NPI# 1760704878) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760704878 |
| Entity Type | Organization |
| Organization Name | PEACEHEALTH |
| Other Organization Name | PEACEHEALTH MEDICAL GROUP-DEXTER |
| Practice Address |
38843 Dexter Rd Dexter OR 97431-0110 |
| Mailing Address |
Po Box 24410 Eugene OR 97402-0451 |
| Practice Telephone | 5419372134 |
| Mailing Telephone | 5419844301 |
| Enumeration Date | 2010-02-17 |
| Last Update Date | 2010-09-10 |
| Authorized Official Name | WENDY APLAND (CFO) |
| Authorized Official Telephone | 5416863968 |
| Is Organization Subpart | Y |
| Parent Organization Name | PEACEHEALTH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE PART A PTAN | 38 3808 | 01 |
| Other Name | Type Code |
|---|---|
| PEACEHEALTH MEDICAL GROUP-DEXTER | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255977591 | Peacehealth | Durable Medical Equipment & Medical Supplies | 625 9th Ave Ste 120, Longview, WA 98632-2465 | 2019-11-21 |
| 1184106437 | Peacehealth | Durable Medical Equipment & Medical Supplies | Triangle Mall Suite 16 1015 Ocean Beach Hwy, Longview, WA 98632 | 2018-09-04 |
| 1669766457 | Peacehealth | General Acute Care Hospital | 787 Woodland Acres Ln, Eugene, OR 97402-9378 | 2011-06-09 |
| 1760427082 | Peacehealth | Home Health | 126 Washington St, Ketchikan, AK 99901-5930 | 2006-06-19 |
| 1912957986 | Peacehealth | Clinical Medical Laboratory | 123 International Way, Springfield, OR 97477-1047 | 2006-05-11 |
| 1083672273 | Peacehealth | Rehabilitation Unit | 809 E Chestnut St, Bellingham, WA 98225-5221 | 2006-05-04 |
| 1447217559 | Peacehealth | Hospice, Inpatient | 2800 Douglas Avenue, Bellingham, WA 98225 | 2006-05-01 |
| 1215918719 | Peacehealth | Hospice Care, Community Based | 2230 Kingwood Street, Florence, OR 97439-9470 | 2005-11-10 |
| 1225019011 | Peacehealth | Home Health | 2230 Kingwood St, Florence, OR 97439-9464 | 2005-11-08 |
| 1346237971 | Peacehealth | General Acute Care Hospital | 1255 Hilyard St, Eugene, OR 97401-3718 | 2005-09-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PEACEHEALTH | 1115 Se 164th Avenue, Vancouver, WA 98683-9324 |
| Washington State Corporations | PEACEHEALTH | 1115 Se 164th Ave Dept. 302, Vancouver, WA 98683 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH | 1115 Se 164th Ave Dept 302, Vancouver, WA 98683 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH - COTTAGE GROVE | 1515 Village Dr, Cottage Grove, OR 97424 |
| Washington State Corporations | PEACEHEALTH ASC BELLINGHAM, LLC | 1115 Se 164th Ave, Dept 302, Vancouver, WA 98683-9324 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH COTTAGE GROVE COMMUNITY MEDICAL CENTER | 1515 Village Dr, Cottage Grove, OR 97424 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH COTTAGE GROVE COMMUNITY MEDICAL CENTER FOUNDATION | 1515 Village Dr, Cottage Grove, OR 97424 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH COTTAGE GROVE COMMUNITY MEDICAL CENTER SWING | 1515 Village Drive, Cottage Grove, OR 97424 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH HOSPITAL MEDICINE | 3333 Riverbend Dr, Springfield, OR 97477 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH LABORATORIES | 123 International Way, Springfield, OR 97477 |
| Street Address |
38843 DEXTER RD |
| City | DEXTER |
| State | OR |
| Zip Code | 97431-0110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710923651 | The Lakeside Clinic | Clinic/Center | 38843 Dexter Rd, Dexter, OR 97431-9775 | 2006-06-21 |
| 1104264068 | Peacehealth | Clinic/Center | 38843 Dexter Rd, Dexter, OR 97431-9600 | 2013-06-12 |
| 1134157332 | Mary L Fey | Nurse Practitioner | 38843 Dexter Rd, Dexter, OR 97431-9775 | 2006-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508175472 | Jennifer L. Stephens | Nurse Practitioner | 38843 Dexter Road, Dexter, OR 97431 | 2010-09-27 |
| 1659400315 | Susan Kay Kasten | Registered Nurse | 38469 Dexter Rd, Dexter, OR 97431-9725 | 2007-03-05 |
| 1407395478 | Amber Norton | Registered Nurse | 83717 Rattlesnake Rd, Dexter, OR 97431-9755 | 2017-02-23 |
| 1942272877 | Janine Gordon | Psychiatry & Neurology | 82211 Mt Zion Dr, Dexter, OR 97431-9779 | 2006-02-04 |
| 1972912012 | Deborah Vukson | Massage Therapist | 80881 Lost Creek Rd, Dexter, OR 97431-9782 | 2014-08-02 |
| 1861726267 | Renee Bisnaire | Midwife, Lay | 82087 Lost Creek Rd, Dexter, OR 97431-9783 | 2009-10-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902355 | Aaron Kate Menley | Pharmacist | 2025 West Business Highway 60, Dexter, MO 63841-6384 | 2020-11-03 |
| 1417558941 | Christa Renee Mcbroom | Pharmacist | 2025 Business Hwy 60w, Dexter, MO 63841 | 2020-11-02 |
| 1225637838 | Summer Lynn Mcgowan | Counselor | 12040 Southern Breeze, Dexter, MO 63841-2890 | 2020-10-23 |
| 1104423037 | Mariana Medina | Behavior Technician | 6488 Beard St, Dexter, NM 88230-9733 | 2020-10-05 |
| 1043825862 | Christopher Graham | Nurse Practitioner | 2275 Bass Rd, Dexter, GA 31019-3625 | 2020-09-09 |
| 1396357141 | Melissa Ann Lovins-bewley | Nurse Practitioner | 14484 County Road 640, Dexter, MO 63841-8667 | 2020-08-21 |
| 1467062612 | Welcome Home Assisted Living, LLC | Assisted Living Facility | 5 Adams Dr, Dexter, MO 63841-1985 | 2020-08-03 |
| 1467061556 | Brett Johnson | Social Worker | 7200 Dan Hoey Rd Ste G2, Dexter, MI 48130-4201 | 2020-07-24 |
| 1346858800 | Lauren Williams | Pharmacist | 2290 Melbourne Ave Apt 1008, Dexter, MI 48130-2504 | 2020-07-21 |
| 1710504675 | Nwd Enteprises, LLC | Home Health | 7910 Ann Arbor St Ste 2, Dexter, MI 48130-1344 | 2020-06-26 |
| Find all providers in DEXTER | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225161474 | Roswell Hospital Corporation | Clinic/Center | 116 East 2nd Street, Dexter, NM 88230 | 2007-03-14 |
| 1710923651 | The Lakeside Clinic | Clinic/Center | 38843 Dexter Rd, Dexter, OR 97431-9775 | 2006-06-21 |
| 1700821212 | Poplar Bluff Regional Medical Center LLC | Clinic/Center | 610 N One Mile Rd, Dexter, MO 63841-2539 | 2006-06-18 |
| 1104264068 | Peacehealth | Clinic/Center | 38843 Dexter Rd, Dexter, OR 97431-9600 | 2013-06-12 |
| 1457660045 | Southeast Health Center of Stoddard County, LLC | Clinic/Center | 2025 W Business Us Highway 60, Dexter, MO 63841-2879 | 2010-09-29 |
| 1083848923 | Stoddard County Family Care LLC | Clinic/Center | 1300 N One Mile Rd, Dexter, MO 63841-1042 | 2009-05-06 |
| 1629111729 | Southeast Health Center of Stoddard County LLC | Clinic/Center | 1300 N One Mile Rd, Dexter, MO 63841-1042 | 2007-02-15 |
| 1790828812 | Southeast Health Center of Stoddard County, LLC | Clinic/Center | 1200 N One Mile Rd, Dexter, MO 63841-1000 | 2007-02-15 |
| 1710047618 | Southeast Health Center of Stoddard County, LLC | Clinic/Center | 1300 N One Mile Rd, Suite 2, Dexter, MO 63841-1042 | 2006-12-11 |
| 1083633374 | William Newton Memorial Hospital | Clinic/Center | 204 North Main, Dexter, KS 67038 | 2006-07-18 |
| Find all providers in DEXTER | ||||
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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.