Asante
Organization Active NPI Psychiatric Hospital Unit · Medford, OR
NPI 1114002128 · NPPES record last updated Feb 22, 2024
Key facts
- NPI
- 1114002128
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric Hospital Unit 273R00000X
- Legal business name
- ASANTE
- Practice address
- 2825 E Barnett Rd
Medford, OR 97504-8332 - Phone
- (541) 789-7000
- Fax
- (541) 789-5393
- NPI assigned
- Oct 26, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- ASANTE
Authorized official
- Name
- Heather J Rowenhorst
- Title
- Cfo
- Phone
- (541) 789-4549
Owners & managing parties with NPI records 6
-
Brian W Gross, M.D.
-
Suzin M Hagar, MD
Owned or controlled facilities with NPI records 7
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 4
Related certifications (CCN) 1
Facilities with the same owner 7
Practitioners 141
-
Gabrielle A Anderson, DNP
-
Pragathi Balakrishna, M.D.
-
Jasmine B Barnhart, FNP
-
Alicia G Bond, MD
-
John Adam Bonk, MD
-
Revaz Boukia, PA-C
-
Rodney Camp, DO
-
Peter Canning, M.D.
-
Kelly Eileen Church, FNP
-
Joshua M. Cott, MD
-
Kelly A Dale, NP
-
Beni Thi Dang, PA-C
-
Kent W Dauterman, MD
-
Nicolaas W De Wette, M.D.
-
Rachel Dunn, FNP
-
Ashish Dutta Dwary, MBBS
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OR
Hospital certification: CCN 38S018
- Legal name
- ASANTE
- Doing business as
- ASANTE ROGUE REGIONAL MEDICAL CENTER
- Organization structure
- Corporation · Non-profit
- Incorporated
- Mar 13, 1936 in OR
- Enrollment address
- 2825 E Barnett Rd
Medford, OR 97504-8332 - Hospital subgroups
- Psychiatric
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| Asante |
Operational/Managerial Control | Nov 21, 2007 | 100% |
| Patricia Wintemute |
Corporate Director |
Jan 1, 2020 | |
| Gregory G Wojtal |
Corporate Officer |
Jan 9, 2017 | |
| Christina Medina |
Corporate Director |
Jan 1, 2022 | |
| Peter Angstadt |
Corporate Director |
Jan 1, 2015 | |
| Michael Zdeblick |
Corporate Officer |
Jan 1, 2011 | |
| Kate Lasky |
Corporate Director |
Jan 1, 2022 | |
| Toni a Bartling |
W-2 Managing Employee |
Jan 1, 2019 | |
| Brian W Gross |
Corporate Director |
Jan 1, 2020 | |
| Suzin M Hagar |
Corporate Director |
Jan 1, 2022 | |
| Stephen Gambee |
Corporate Director |
Jan 1, 2020 | |
| Ken Trautman |
Corporate Director |
Jan 1, 2017 | |
| Douglass Schmor |
Corporate Director |
Jan 1, 2015 | |
| Sandra Slattery |
Corporate Director |
Jan 1, 2016 |
All facility ownership & control disclosures 8
| Facility | Type | Role | Since |
|---|---|---|---|
| Asante Rogue Regional Medical Center |
Hospital | Operational/Managerial Control (100%) | Nov 21, 2007 |
| Asante Three Rivers Medical Center LLC |
Hospital | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Aug 1, 2004 Nov 21, 2007 |
| Asante Rogue Regional Medical Center |
Hospital | Operational/Managerial Control (100%) | Nov 21, 2007 |
| Asante Ashland Community Hospital LLC |
Hospital | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Feb 27, 2017 Feb 28, 2017 |
| Asante Ashland Community Hospital LLC |
Hospital | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Feb 28, 2017 Feb 28, 2017 |
| Assured Home Health |
Home health agency | 5% Or Greater Direct Ownership Interest (25%) | Sep 1, 2009 |
| Accentcare Home Health of Rogue Valley, LLC |
Home health agency | 5% Or Greater Direct Ownership Interest (25%) | Nov 9, 2013 |
| Asante Rogue Regional Medical Center Hospice Services |
Hospice | Operational/Managerial Control (100%) | Nov 21, 2007 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031219000238 | OR | Part B Supplier - Clinic/Group Practice | 0547177321 |
Receives reassigned benefits from 292 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Medford, OR |
| O20070921000506 | OR | Part a Provider - Hospital | 0547177321 | Practice locations: Medford, OR |
National Provider Directory
- Part of
- Jacksonville Clinic
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital Unit | 273R00000X | Yes |
Addresses
Primary practice location
2825 E Barnett Rd
Medford, OR 97504-8332
Mailing address
PO Box 4749
Medford, OR 97501-0227
Phone (541) 789-5516
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500604342 | Medicaid | OR |
Other names
- Asante Rogue Regional Medical Center BHU
Other providers in Medford, OR
- Melody Jane Arnspiger
- Rishi Shravan Arora
- Kirsten Arreguin
- Xavier William Arthur
- Brandy E Artman
- Asante
- Asante
- Asante
- Asante
- Asante
All providers in Medford, OR · Psychiatric Hospital Unit in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.