NPIMap

Organization Active NPI

Columbia Lutheran Charities

  • Community Based Hospice Care Agency
  • Astoria, OR
National Provider Identifier
1023038858
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
COLUMBIA LUTHERAN CHARITIES
Practice address
2120 Exchange St Ste 203
Astoria, OR 97103-3364
Phone
(503) 338-6230
Fax
(503) 338-6240
NPI assigned
Jul 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Authorized official

Name
Mr. Erik Thorsen
Title
Chief Executive Officer
Phone
(503) 325-4321

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

2120 Exchange St Ste 203
Astoria, OR 97103-3364

Mailing address

2111 Exchange St
Astoria, OR 97103-3329
Phone (503) 325-4321

Other identifiers 1

IdentifierTypeStateIssuer
131891MedicaidOR

Other names 1

  • Lower Columbia Hospice Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040202000073 OR Part B Supplier - Clinic/Group Practice 5294643359 Receives reassigned benefits from 208 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Warrenton, OR; Astoria, OR
O20070323000415 OR Part A Provider - Hospice 5294643359 Practice locations: Astoria, OR

Hospice certification: CCN 381520

Legal name
COLUMBIA LUTHERAN CHARITIES
Doing business as
LOWER COLUMBIA HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
May 29, 1991
Last certification
Feb 12, 2020
Ownership / control type
Non-Profit - Church
Organization structure
CorporationNon-profit
Incorporated
Oct 8, 1958 in OR
Enrollment address
2120 Exchange St
Ste 203
Astoria, OR 97103-3364

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 5

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Lower Columbia HospiceCCN 381520
Ownership
Non-Profit
Certified
May 29, 1991
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Dennis Winner13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

486 12th St
Astoria, OR 97103
Phone (503) 338-6230

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
Paul Haines Individual Corporate DirectorBoard Member Nov 5, 2020 5%
Patricia J Danforth Individual Corporate DirectorBoard Member Jan 1, 2017 5%
Doug Kaup Individual Corporate DirectorBoard Member Dec 1, 2016
Matthew Phillips Individual Corporate DirectorBoard Member Nov 5, 2020 5%
Erik W Thorsen Individual Corporate Director May 22, 1991
W-2 Managing EmployeeAd; May 22, 1991
Robert L Holland Individual Corporate DirectorBoard Member Dec 5, 2013
David Nygaard Individual Corporate DirectorBoard Member Dec 31, 2016
Anisa M Richardson Individual W-2 Managing EmployeeMD; Apr 1, 2020
Columbia Lutheran Charities Organization, Astoria, OR Non-profit 5% Or Greater Direct Ownership Interest May 22, 1991
Constance Carol Waisanen Individual Corporate DirectorBoard Member Mar 5, 2009
Mike Autio Individual Corporate DirectorBoard Member Apr 12, 2018
Rhonda Conrad Individual W-2 Managing EmployeeHospice Manager May 7, 2018 5%
Mark Smith Individual Corporate DirectorBoard Member Dec 1, 2013
Quratulain Durrani Individual Corporate DirectorBoard Member Aug 15, 2022
James a Heilman Individual Corporate DirectorBoard Member May 2, 2019 5%
Heather Ann Seppa Individual Corporate DirectorBoard Member Nov 1, 2007
Nancy R McAllister Individual Corporate DirectorBoard Member Apr 23, 1992
William Walter Landwehr Individual Corporate DirectorBoard Member Jan 8, 2009

Owners & managing parties with NPI records 10

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

Practitioners & affiliated clinicians

Practitioners 418

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

View all 418

Affiliated clinicians 8

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717372800000",
    "number": "1023038858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 EXCHANGE ST",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971033329",
            "telephone_number": "503-325-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 EXCHANGE ST STE 203",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971033364",
            "telephone_number": "503-338-6230",
            "fax_number": "503-338-6240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA LUTHERAN CHARITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A",
        "authorized_official_last_name": "THORSEN",
        "authorized_official_first_name": "ERIK",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "503-325-4321",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131891",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lower Columbia Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Astoria, OR

Sources for this page

Verify at the official NPI Registry.