NPIMap

Organization Active NPI

La Clinica del Valle Family Healthcare Center Inc.

  • Federally Qualified Health Center (FQHC)
  • Medford, OR
National Provider Identifier
1184237489
Registry record updated Aug 26, 2020
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 HEALTHCARE CENTER INC.
Practice address
1011 La Loma Dr
Medford, OR 97504-8613
Phone
(541) 779-1766
Fax
(541) 512-2082
NPI assigned
Aug 26, 2020
Organization subpart
Yes
Parent organization
LA CLINICA DEL VALLE FAMILY HEALTHCARE CENTER INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 26, 2020

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

1011 La Loma Dr
Medford, OR 97504-8613

Mailing address

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

Other names 1

  • School Based Health Center- Orchard Hill Elementary School Other name

National Provider Directory

National Provider Directory
Tax ID family
La Clinica del Valle Family Health Care Center Inc33 organizations share this tax ID, including this one
Part of
La Clinica del Valle Family Health Care Center Inc

Other organizations with this tax ID 32

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

View all 32

Locations

1011 La Loma Dr
Medford, OR 97504
Phone (541) 779-1766

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1598400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598400000000",
    "number": "1184237489",
    "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",
            "fax_number": "541-842-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 LA LOMA DR",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048613",
            "telephone_number": "541-779-1766",
            "fax_number": "541-512-2082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA CLINICA DEL VALLE FAMILY HEALTHCARE CENTER INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LA CLINICA DEL VALLE FAMILY HEALTHCARE CENTER INC.",
        "enumeration_date": "2020-08-26",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-24",
        "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": "School Based Health Center- Orchard Hill Elementary School",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; 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.