Organization Active NPI

McKay Creek Community Healthcare LLC

  • Assisted Living Facility
  • Pendleton, OR
National Provider Identifier
1104666353
Registry record updated May 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
MCKAY CREEK COMMUNITY HEALTHCARE LLC
Doing business as
McKay Creek Assisted Living
Practice address
1601 Southgate PL
Pendleton, OR 97801-9432
Phone
(541) 276-1987
NPI assigned
May 27, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2024

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

Authorized official

Name
John Mitchell
Title
Secretary
Phone
(801) 447-9829

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

1601 Southgate PL
Pendleton, OR 97801-9432

Mailing address

262 N University Ave
Farmington, UT 84025-2975

Other names 1

  • McKay Creek Assisted Living Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D2270780McKay Creek Assisted Living1601 Southgate PL, Pendleton, OR 97801Certificate of waiverOct 19, 2026

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1716768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716768000000",
    "number": "1104666353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 N UNIVERSITY AVE",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "840252975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 SOUTHGATE PL",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978019432",
            "telephone_number": "541-276-1987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCKAY CREEK COMMUNITY HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-27",
        "last_updated": "2024-05-27",
        "certification_date": "2024-05-27",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "801-447-9829"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McKay Creek Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pendleton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.