Cow Creek Band of Umpqua Tribe of Indians
Organization Active NPI Federally Qualified Health Center (FQHC) · Canyonville, OR
NPI 1134567993 · NPPES record last updated Aug 5, 2021
Key facts
- NPI
- 1134567993
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- COW CREEK BAND OF UMPQUA TRIBE OF INDIANS
- Practice address
- 480 Wartahoo LN
Canyonville, OR 97417-9683 - Phone
- (541) 839-1345
- Fax
- (855) 670-1791
- NPI assigned
- Jun 13, 2013
- Organization subpart
- No
Authorized official
- Name
- Sharon A Stanphill
- Title
- Chief Health Officer
- Phone
- (541) 672-8533
Corporate family (same tax ID) 2
Practitioners 70
-
Holly Leanne Anderson-Caldwell, LCSW, CDC I
-
Mark Eugene Barnstable, LCSW
-
Julia Barth, BS
-
Amber Cooper, APRN-NP
-
Tiffany Gage, LCSW, CDC I
-
Amy M Lamb, FNP
-
Kevin Harry Lee, DO
-
Ross Albert Leonard, D.P.M.
-
Charity B McSperitt, CSWA
-
Valerie Lee Reneau, LMT
-
Jennifer Rebecca Schenk, FNP-C
-
Kimberly Ann Talley, APRN
-
Micah D Tovey, DPM
-
Thomas S Turk, M.D.
-
Leeandria N. Witcraft, LCSW
-
Kim Bagby, APRN
-
Dawn Rae Bankson, CPNP
-
Chelesia Burkes-Brown, PMHNP
National Provider Directory
- Tax ID family
- Cow Creek Band of Umpqua Tribe of Indians
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
480 Wartahoo LN
Canyonville, OR 97417-9683
Mailing address
2371 NE Stephens St
Suite 200
Roseburg, OR 97470-1372
Phone (541) 672-8533
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500745176 | Medicaid | OR |
Other names
- Cow Creek Health & Wellness Center
Other providers in Canyonville, OR
- Bonita Acosta
- Shari Lavida Allen
- Robert Bakkegard
- Canyonville Chiropractic Inc
- Richard Edward Cooksley
- Cow Creek Health & Wellness Annex
- Donato and Wood Consulting Inc
- Donato and Wood Consulting, Inc
- Dr Anna LLC
- Falk Family Medicine, LLC
All providers in Canyonville, OR · Federally Qualified Health Center (FQHC) in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 5, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.