LA PINE COMMUNITY HEALTH CENTER (NPI# 1821472366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821472366 |
| Entity Type | Organization |
| Organization Name | LA PINE COMMUNITY HEALTH CENTER |
| Practice Address |
87520 Bay Road Christmas Valley OR 97641 |
| Mailing Address |
Po Box 3300 La Pine OR 97739-3300 |
| Practice Telephone | 5415363435 |
| Mailing Telephone | 5415363435 |
| Mailing Fax Number | 5415363332 |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2015-07-22 |
| Authorized Official Name | CHARLA DEHATE (CEO) |
| Authorized Official Telephone | 5415363435 |
| Is Organization Subpart | Y |
| Parent Organization Name | LA PINE COMMUNITY HEALTH CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669889341 | La Pine Community Health Center | Clinic/Center | 350 Mississippi Dr, Gilchrist, OR 97737-3243 | 2014-07-15 |
| 1063825776 | La Pine Community Health Center | Clinic/Center | 51605 Coach Road, La Pine, OR 97739-7556 | 2014-06-10 |
| 1639316193 | La Pine Community Health Center | Clinic/Center | 51600 Huntington Road, Suite C, La Pine, OR 97739-0001 | 2009-01-20 |
| 1598119075 | La Pine Community Health Center | Clinic/Center | 51340 Highway 97, La Pine, OR 97739-9871 | 2016-04-20 |
| 1174919674 | La Pine Community Health Center | Clinic/Center | 56881 Enterprise Dr, Sunriver, OR 97707-2120 | 2015-04-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | LA PINE COMMUNITY HEALTH CENTER | 51600 Huntington Rd, La Pine, OR 97739 |
| Street Address |
87520 BAY ROAD |
| City | CHRISTMAS VALLEY |
| State | OR |
| Zip Code | 97641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245234285 | Central Cascades Physical Therapy | Physical Therapist | 87520 Bay Road, Christmas Valley, OR 97641-0001 | 2005-06-08 |
| 1326042367 | Grover Dean Cockrum | Physical Therapist | 87520 Bay Road, Christmas Valley, OR 97641-0000 | 2005-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114153210 | Shawn Kimberly Lavallee | Massage Therapist | 87520 Bay Rd., North Lake Clinic, Christmas Valley, OR 97641 | 2009-06-03 |
| 1851456305 | Bruce D Carlson M.d. | Clinic/Center | 87480 Spruce Ln, Christmas Valley, OR 97641 | 2006-12-26 |
| 1497810915 | Dennis M. Bruneau | Physician Assistant | 87520 Bay Rd, Christmas Valley, OR 97641-0377 | 2006-12-26 |
| 1457745101 | Pat Widenoja Fnp | Clinic/Center | 87520 Bay Rd, Pob 377, Christmas Valley, OR 97641-0377 | 2015-03-20 |
| 1669607792 | North Lake Clinic, LLC | Clinic/Center | 87520 Bay Rd, Christmas Valley, OR 97641-0377 | 2009-05-19 |
| 1780714824 | North Lake County Emergency Medical Service, Inc. | Ambulance | 87391 Holly Lane, Christmas Valley, OR 97641-0423 | 2007-03-07 |
| 1285124081 | Jama Lynn Nelson | Case Manager/Care Coordinator | 87127 Christmas Valley Hwy, Christmas Valley, OR 97641-2298 | 2018-05-16 |
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1922656289 | Clackamas County | Clinic/Center | 39831 Highway 26, Sandy, OR 97055-6558 | 2019-08-29 |
| 1063067312 | Virginia Garcia Memorial Health Center | Clinic/Center | 11300 Sw Hazelbrook Rd, Tualatin, OR 97062-6980 | 2019-08-05 |
| 1417411505 | Klamath Health Partnership, Inc | Clinic/Center | 2210 N Eldorado Ave Ste A, Klamath Falls, OR 97601-6418 | 2019-01-23 |
| 1679053946 | Siskiyou Community Health Center Inc | Clinic/Center | 830 Ne 9th St, Grants Pass, OR 97526-1626 | 2018-08-16 |
| 1427563733 | Central City Concern Inc | Clinic/Center | 1415 Se 122nd Ave, Portland, OR 97233 | 2017-12-08 |
| 1598284242 | Winding Waters Medical Clinic | Clinic/Center | 401b N Main St, Joseph, OR 97846-5030 | 2017-09-13 |
| 1750807111 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 821 N Riverside Ave, Medford, OR 97501 | 2017-08-17 |
| 1477005619 | Outside In | Clinic/Center | 1226 Sw 12th Ave, Portland, OR 97205-2029 | 2016-11-03 |
| Find all providers with the same taxonomy | ||||
| City | CHRISTMAS VALLEY |
| Zip Code | 97641 |
Please comment or provide details below to improve the information on LA PINE COMMUNITY HEALTH CENTER.
| 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.