NPIMap

Organization Active NPI

Willamette Family Medical Center, Inc

  • Family Medicine Physician
  • Falls City, OR
National Provider Identifier
1043483886
Registry record updated Apr 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WILLAMETTE FAMILY MEDICAL CENTER, INC
Practice address
304 N Main St
Falls City, OR 97344-9793
Phone
(503) 787-3353
Fax
(503) 787-2911
NPI assigned
Apr 11, 2008
Last updated
Apr 11, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2008

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

Authorized official

Name
Dr. Robert SteeleNPI 1265548036
Title
Medical Director
Phone
(503) 585-6388

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

304 N Main St
Falls City, OR 97344-9793

Mailing address

755 Medical Center Dr NE
Salem, OR 97301-2762
Phone (503) 585-6388

Other names 1

  • Luckiamute Clinic Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040402000465 OR Part B Supplier - Clinic/Group Practice 0749272201 Receives reassigned benefits from 28 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Salem, OR

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Locations

435 Lancaster Dr NE
Salem, OR 97301
Phone (503) 585-6388

Practitioners & affiliated clinicians

Practitioners 7

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": "1207872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207872000000",
    "number": "1043483886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 MEDICAL CENTER DR NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012762",
            "telephone_number": "503-585-6388",
            "fax_number": "503-485-3951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 N MAIN ST",
            "city": "FALLS CITY",
            "state": "OR",
            "postal_code": "973449793",
            "telephone_number": "503-787-3353",
            "fax_number": "503-787-2911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLAMETTE FAMILY MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-11",
        "last_updated": "2008-04-11",
        "status": "A",
        "authorized_official_last_name": "STEELE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "503-585-6388",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Luckiamute Clinic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Falls City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2008; 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.