Small Town Pediatrics LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

SMALL TOWN PEDIATRICS LLC

Practice address

607 Welch St
Silverton, OR 97381-1946

Phone

(503) 400-3852

Fax

(503) 334-2268

NPI assigned

Jun 29, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Douglas Scott Hamblin, MD

Title

Owner/Pediatrician

Phone

(971) 304-9855

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark E Helm, MD, MBA

  • Pediatrics Physician
  • Silverton, OR
  • NPI 1811060122
  NPD
• Jessica Ytieve Chaney, CPNP

  • Pediatric Nurse Practitioner
  • Hillsboro, OR
  • NPI 1720714264
  NPD (past)
• Samantha Leigh Clark, C-PNP

  • Pediatric Nurse Practitioner
  • Keizer, OR
  • NPI 1841908894
  NPD (past)
• Valarie Chrystal Mill, DNP

  • Family Nurse Practitioner
  • Warrenton, OR
  • NPI 1598463119
  NPD (past)

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624924800000",
    "number": "1134799489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1430",
            "city": "SILVERTON",
            "state": "OR",
            "postal_code": "973810106",
            "telephone_number": "503-400-3852",
            "fax_number": "503-334-2268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 WELCH ST",
            "city": "SILVERTON",
            "state": "OR",
            "postal_code": "973811946",
            "telephone_number": "503-400-3852",
            "fax_number": "503-334-2268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMALL TOWN PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-29",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A",
        "authorized_official_last_name": "HAMBLIN",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER/PEDIATRICIAN",
        "authorized_official_telephone_number": "971-304-9855",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500675213",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Silverton",
            "affiliation": "N",
            "address_1": "607 Welch St",
            "city": "Silverton",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973811946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Silverton Hospital Pharmacy
• Silverton Surgical,LLC
• Christine Simpson
• Lisa Sinclair
• Michelle Lucille Sinn, LPTA
• Samantha Brooke Smith-Fischer, CPT
• Anthony Nelson Smith, P.A.
• Daniel Lawrence Smith
• Jessica Marie Smith, LMT
• Robin Smith

• Pediatrics Physician in Silverton, OR
• Providers in Silverton, OR by specialty
• Pediatrics Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; 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.