NPIMap

Organization Active NPI

Willamette Valley Clinics LLC

  • Family Medicine Physician
  • Sheridan, OR
National Provider Identifier
1033173604
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WILLAMETTE VALLEY CLINICS LLC
Practice address
222 SE Jefferson St
Sheridan, OR 97378-1924
Phone
(503) 843-4909
NPI assigned
Apr 12, 2006
Last updated
Sep 24, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
WILLAMETTE VALLEY CLINICS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Authorized official

Name
Charlotte Lawrence
Title
Secretary
Phone
(615) 920-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

222 SE Jefferson St
Sheridan, OR 97378-1924

Mailing address

7100 Commerce Way
Ste. 180
Brentwood, TN 37027-2829
Phone (615) 465-7626

Other identifiers 1

IdentifierTypeStateIssuer
287735MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040127000785 OR Part B Supplier - Clinic/Group Practice 6103729314 Receives reassigned benefits from 81 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sheridan, OR; McMinnville, OR

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Willamette Valley Med C5 organizations share this tax ID, including this one
Part of
Willamette Valley Med C

Other organizations with this tax ID 4

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

Locations

2700 SE Stratus Ave
McMinnville, OR 97128
Phone (503) 435-1200

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1814/brand/22/csg/69/fhir/r4

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727136000000",
    "number": "1033173604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 COMMERCE WAY",
            "address_2": "STE. 180",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370272829",
            "telephone_number": "615-465-7626",
            "fax_number": "615-465-3007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 SE JEFFERSON ST",
            "city": "SHERIDAN",
            "state": "OR",
            "postal_code": "973781924",
            "telephone_number": "503-843-4909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLAMETTE VALLEY CLINICS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WILLAMETTE VALLEY CLINICS, LLC",
        "enumeration_date": "2006-04-12",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "615-920-7000"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287735",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheridan, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.