NPIMap

Organization Active NPI

La Clinica del Valle Family Health Care Center Inc

  • Federally Qualified Health Center (FQHC)
  • Central Point, OR
National Provider Identifier
1114651171
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC
Practice address
600 S 2ND St
Central Point, OR 97502-2704
Phone
(541) 535-6239
NPI assigned
Jul 14, 2022
Last updated
Jul 14, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 14, 2022

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

Authorized official

Name
Traci Fossen
Title
Chief Quality Officer
Phone
(541) 512-3912

Specialties & licenses 1

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

Addresses

Primary practice location

600 S 2ND St
Central Point, OR 97502-2704

Mailing address

931 Chevy Way
Medford, OR 97504-4127
Phone (541) 535-6239

Other names 1

  • La Clinica School-Based Health Center at Rogue Primary School Other name

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
38D2264912La Clinica School-Based Health Center at600 S 2ND Street, Central Point, OR 97502Certificate of waiverJul 19, 2028

National Provider Directory

National Provider Directory
Tax ID family
La Clinica del Valle Family33 organizations share this tax ID, including this one
Part of
La Clinica del Valle Family

Other organizations with this tax ID 32

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

View all 32

Ownership & related parties

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.

NPI Registry JSON

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

{
    "created_epoch": "1657756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657756800000",
    "number": "1114651171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 CHEVY WAY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044127",
            "telephone_number": "541-535-6239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S 2ND ST",
            "city": "CENTRAL POINT",
            "state": "OR",
            "postal_code": "975022704",
            "telephone_number": "541-535-6239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC.",
        "enumeration_date": "2022-07-14",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-05",
        "status": "A",
        "authorized_official_last_name": "FOSSEN",
        "authorized_official_first_name": "TRACI",
        "authorized_official_title_or_position": "CHIEF QUALITY OFFICER",
        "authorized_official_telephone_number": "541-512-3912"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "La Clinica School-Based Health Center at Rogue Primary School",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Central Point, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; 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.