NPIMap

Organization Active NPI

Neighborhood Health Center

  • Federally Qualified Health Center (FQHC)
  • Milwaukie, OR
National Provider Identifier
1083984264
Registry record updated Apr 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NEIGHBORHOOD HEALTH CENTER
Practice address
10330 SE 32ND Ave Ste 325
Milwaukie, OR 97222
Phone
(503) 416-1960
Fax
(503) 416-1959
NPI assigned
Jan 5, 2012
Last updated
Apr 26, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
NEIGHBORHOOD HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 26, 2023

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

Authorized official

Name
Blain West, CPA
Title
Cfo
Phone
(503) 941-3033

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X OR Primary

Addresses

Primary practice location

10330 SE 32ND Ave Ste 325
Milwaukie, OR 97222

Mailing address

7320 SW Hunziker Rd Ste 300
Portland, OR 97223-2302
Phone (503) 941-3033

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110802000211 OR Part B Supplier - Clinic/Group Practice 8426227893 Receives reassigned benefits from 37 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Oregon City, OR; Portland, OR; Milwaukie, OR; Hillsboro, OR; Canby, OR
O20140421001132 OR Part A Provider - Federally Qualified Health Center (FQHC) 8426227893 Practice locations: Milwaukie, OR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083984264. Details of each certification follow.

Federally qualified health center certification: CCN 381945

Legal name
NEIGHBORHOOD HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 12, 2014
Last certification
Mar 12, 2014
Ownership / control type
Non-profit – corporation
Organization structure
OtherNon-profit
Incorporated
Oct 1, 2010 in OR
Enrollment address
10330 SE 32ND Ave 325
Milwaukie, OR 97222-6656

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Tax ID family
Neighborhood Health Center9 organizations share this tax ID, including this one
Part of
Neighborhood Health Center

Other organizations with this tax ID 8

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

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Rudy Mazza Individual Corporate Officer Jan 1, 2020
Ashley Morales Individual Corporate DirectorBoard Member Jul 1, 2023 9%
Steven Kinder Individual Corporate Officer Jan 1, 2020
Jeri Weeks Individual Corporate OfficerCeo Sep 1, 2011
W-2 Managing EmployeeCeo Sep 1, 2011
Mary a Fitzpatrick Individual Corporate DirectorBoard Member Nov 5, 2024
Wayne Schmidt Individual Corporate OfficerSecretary Jan 1, 2020
Blain West Individual Corporate DirectorCfo Jun 1, 2011
Brett Hamilton Individual Corporate DirectorBoard Member Feb 1, 2024
Brittany Marks Individual Corporate OfficerBoard Co-Chair Jul 1, 2013
Donnamarie Intericola Individual Corporate DirectorBoard Member Apr 2, 2024
Donalda Dodson Individual Corporate OfficerBoard Co-Chair Oct 1, 2010

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Neighborhood Health CenterHillsboro, OR, CCN 381949 Federally qualified health center Other (100%) Feb 10, 2014

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 61

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 61

NPI Registry JSON

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

{
    "created_epoch": "1325721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682467200000",
    "number": "1083984264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7320 SW HUNZIKER RD STE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972232302",
            "telephone_number": "503-941-3033",
            "fax_number": "503-747-7013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10330 SE 32ND AVE STE 325",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "97222",
            "telephone_number": "503-416-1960",
            "fax_number": "503-416-1959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIGHBORHOOD HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEIGHBORHOOD HEALTH CENTER",
        "enumeration_date": "2012-01-05",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "BLAIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "503-941-3033",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukie, OR

Sources for this page

Verify at the official NPI Registry.