Pendleton Primary Care Clinic LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PENDLETON PRIMARY CARE CLINIC LLC

Practice address

1100 Southgate Ste 11
Pendleton, OR 97801-3973

Phone

(541) 966-6916

Fax

(541) 215-1405

NPI assigned

Jan 4, 2013

Organization subpart

No

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

Authorized official

Name

Tami J Foster

Title

Office Manager

Phone

(541) 966-6916

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nyle Condit Gunter, PA-C

  • Physician Assistant
  • Boardman, OR
  • NPI 1235753815
  Medicare reassignment
• Bruce D Carlson, M.D.

  • Family Medicine Physician
  • Hermiston, OR
  • NPI 1669537106
  NPD (past)
• Julie A Hughes, FNP-BC

  • Family Nurse Practitioner
  • Pendleton, OR
  • NPI 1154554053
  NPD (past)

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

{
    "created_epoch": "1357257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1013254432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 SOUTHGATE STE 11",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978013973",
            "telephone_number": "541-966-6916",
            "fax_number": "541-215-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 SOUTHGATE STE 11",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978013973",
            "telephone_number": "541-966-6916",
            "fax_number": "541-215-1405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENDLETON PRIMARY CARE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-04",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "TAMI",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "541-966-6916"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pendleton Family Dental LLC
• Pendleton Family Medicine LLC
• Pendleton Family Practice and Sports Medicine LLC
• Pendleton House
• Pendleton Internal Medicine Specialists PC
• Pendleton Ventures LLC
• Leighton T Pennington
• Janet Adele Penny, MD
• Toni Perlot
• Rebecca Nicole Perry

• Primary Care Clinic/Center in Pendleton, OR
• Providers in Pendleton, OR by specialty
• Primary Care Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.