NPIMap

Organization Active NPI

Mid-Valley Healthcare, Inc.

Doing business as Samaritan Lebanon Health Center

  • Rural Health Clinic/Center
  • Lebanon, OR
National Provider Identifier
1003182601
Registry record updated Nov 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MID-VALLEY HEALTHCARE, INC.
Doing business as
Samaritan Lebanon Health Center
Practice address
675 N 5TH St Ste 200
Lebanon, OR 97355
Phone
(541) 451-6282
NPI assigned
Mar 28, 2012
Last updated
Nov 15, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Joseph M Cahill
Title
Ceo
Phone
(541) 451-7914

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

675 N 5TH St Ste 200
Lebanon, OR 97355

Mailing address

675 N 5TH St Ste 200
Lebanon, OR 97355-2875
Phone (541) 451-6282

Other identifiers 1

IdentifierTypeStateIssuer
500651466MedicaidOR

Other names 1

  • Samaritan Lebanon Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031111000297 OR Part B Supplier - Clinic/Group Practice 2769391523 Receives reassigned benefits from 458 practitioners
27 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lebanon, OR; Sweet Home, OR; Newport, OR; Halsey, OR; Brownsville, OR
O20181017002095 OR Part A Provider - Rural Health Clinic 2769391523 Practice locations: Lebanon, OR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003182601. Details of each certification follow.

Rural health clinic certification: CCN 388542

Legal name
MID-VALLEY HEALTHCARE INC
Doing business as
SAMARITAN HEALTH CLINIC -- LEBANON
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 5, 2018
Last certification
Nov 17, 2025
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jun 5, 1950 in OR
Enrollment address
675 N 5TH St
Ste 200
Lebanon, OR 97355-2875
Related CCNs
381323

Facilities connected through Provider of Services related, parent or unit certification numbers.

View all 15

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 27

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 27

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D0626158Samaritan Lebanon Health Center-RHC675 N 5TH St, Lebanon, OR 97355Certificate of waiverApr 5, 2028

National Provider Directory

National Provider Directory

Locations

35 Mullins Dr
Ste 2
Lebanon, OR 97355
Phone (541) 451-7915

Ownership & related parties

All disclosed owners & managing parties 18

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Robert Adams Individual Corporate DirectorBoard of Director Jan 1, 2016
Rachel Hankins Individual Corporate DirectorBoard Member Oct 9, 2018
Samaritan Health Services Inc. Organization, Corvallis, OR For-profit Operational/Managerial Control Jan 1, 1997
Richard C Evans Individual Corporate DirectorBoard of Director Jan 1, 2018
Marsha Philpott Individual Corporate DirectorBoard of Directors Jan 1, 2017
Mirabelle Fernandes Paul Individual Corporate DirectorBoard Member Jan 1, 2025
Loren Roth Individual Corporate DirectorBoard of Director Jan 1, 2017
Joseph Cahill Individual Corporate OfficerCeo Oct 1, 2018
W-2 Managing Employee Oct 1, 2018
Andrew Wimer Individual Corporate DirectorBoard Member Jun 25, 2024
Vanessa R Papalazaros Individual Corporate Director Jan 1, 2025
Wendie Wunderwald Individual Corporate DirectorBoard Member Jan 1, 2025
Jennifer Kimberlain Individual Operational/Managerial ControlAdministrator - SLCH Mar 9, 2026
Richard C Wopat Individual Corporate DirectorBoard Member Jan 1, 2021
Linn Armstrong Individual Corporate DirectorBoard of Director Jan 1, 2016
Randy Springer Individual Corporate DirectorBoard of Director Jan 1, 2017
Brent Kauffman Individual Corporate DirectorBoard of Director Jan 1, 2017
Paula M Crone Individual Corporate DirectorBoard Member Oct 9, 2018
Daniel Burton Smith Individual Corporate OfficerVice President Finance/Cfo Jan 1, 2000 100%

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 21

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 21

Practitioners & affiliated clinicians

Practitioners 63

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 63

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542240000000",
    "number": "1003182601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 N 5TH ST STE 200",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973552875",
            "telephone_number": "541-451-6282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 N 5TH ST STE 200",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "97355",
            "telephone_number": "541-451-6282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-VALLEY HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-28",
        "last_updated": "2018-11-15",
        "status": "A",
        "authorized_official_last_name": "CAHILL",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-451-7914"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500651466",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Samaritan Lebanon Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Samaritan Lebanon Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lebanon, OR

Sources for this page

Verify at the official NPI Registry.