NPIMap

Organization Active NPI

Cow Creek Band of Umpqua Tribe of Indians

Doing business as Cow Creek Health & Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Canyonville, OR
National Provider Identifier
1134567993
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COW CREEK BAND OF UMPQUA TRIBE OF INDIANS
Doing business as
Cow Creek Health & Wellness Center
Practice address
480 Wartahoo LN
Canyonville, OR 97417-9683
Phone
(541) 839-1345
Fax
(855) 670-1791
NPI assigned
Jun 13, 2013
Last updated
Aug 5, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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

Authorized official

Name
Sharon A Stanphill
Title
Chief Health Officer
Phone
(541) 672-8533

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

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 names 1

  • Cow Creek Health & Wellness Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cow Creek Health Wellness Annex3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

2371 NE Stephens St
Ste 200
Roseburg, OR 97470
Phone (541) 672-8533

Practitioners & affiliated clinicians

Practitioners 70

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 70

NPI Registry JSON

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

{
    "created_epoch": "1371081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628121600000",
    "number": "1134567993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2371 NE STEPHENS ST",
            "address_2": "SUITE 200",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974701372",
            "telephone_number": "541-672-8533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 WARTAHOO LN",
            "city": "CANYONVILLE",
            "state": "OR",
            "postal_code": "974179683",
            "telephone_number": "541-839-1345",
            "fax_number": "855-670-1791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COW CREEK BAND OF UMPQUA TRIBE OF INDIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-13",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A",
        "authorized_official_last_name": "STANPHILL",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF HEALTH OFFICER",
        "authorized_official_telephone_number": "541-672-8533"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cow Creek Health & Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cow Creek Health & Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Canyonville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.