Active NPI
Adapt
Doing business as Adapt Integrated Health Care
- Federally Qualified Health Center (FQHC)
- Bandon, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Federally Qualified Health Center (FQHC)
- Legal business name
- ADAPT
- Doing business as
- Adapt Integrated Health Care
- Practice address
- 1010 1St St SE Ste 110
Bandon, OR 97411-9301 - Phone
- (541) 672-2691
- Fax
- (541) 492-0190
- NPI assigned
- Apr 1, 2025
- Last updated
- Oct 23, 2026
- Organization subpart
- Yes
- Parent organization
- ADAPT
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Debbie L Phillips
- Title
- Director of Revenue Cycle
- Phone
- (541) 391-9071
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | Primary |
Addresses
Primary practice location
1010 1St St SE Ste 110
Bandon, OR 97411-9301
Mailing address
621 W Madrone St
Roseburg, OR 97470-3090
Phone (541) 492-0134
Other practice location 1
625 Pioneer Roard
Brookings, OR 97415-8293
Phone (541) 347-2529
Other practice location 2
29516 Ellensburg Ave
Gold Beach, OR 97444-8729
Phone (541) 347-2529
Other practice location 3
1312 Tichenor St
Port Orford, OR 97465-8776
Phone (541) 347-2529
Other names 1
- Adapt Integrated Health Care
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061121000327 | OR | Part B Supplier - Clinic/Group Practice | 4587662887 |
Receives reassigned benefits from 87 practitioners 9 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Bandon, OR; Winston, OR; Roseburg, OR; North Bend, OR; Brookings, OR |
| O20260220002848 | OR | Part A Provider - Federally Qualified Health Center (FQHC) | 4587662887 | Practice locations: Bandon, OR |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1194529289. Details of each certification follow.
Federally qualified health center certification: CCN 381056
- Legal name
- ADAPT
- Doing business as
- ADAPT INTEGRATED HEALTHCARE
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Feb 12, 2026
- Last certification
- Feb 12, 2026
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Enrollment address
- 1010 1St St SE
Ste 110
Bandon, OR 97411-9301
Other NPIs with the same Medicare PAC ID 6
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Adapt Integrated Health Care
- Federally Qualified Health Center (FQHC)
- Roseburg, OR
- NPI 1184350811
4587662887
-
dba North Bend OTP
- Addiction (Substance Use Disorder) Counselor
- North Bend, OR
- NPI 1497248025
4587662887
-
dba SouthRiver Medical Clinic aka: SouthRiver Community Health Center
- Federally Qualified Health Center (FQHC)
- Winston, OR
- NPI 1912061755
4587662887
Other NPIs on the same Medicare enrollment 9
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Adapt Integrated Health Care
- Federally Qualified Health Center (FQHC)
- Roseburg, OR
- NPI 1184350811
O20061121000327
-
dba Compass Behavioral Health
- Community/Behavioral Health Agency
- Roseburg, OR
- NPI 1639682883
O20061121000327
-
- Children's Substance Abuse Rehabilitation Facility
- Roseburg, OR
- NPI 1730362534
O20061121000327
-
dba Adapt Integrated Health Care
- Community/Behavioral Health Agency
- Brookings, OR
- NPI 1760145338
O20061121000327
-
dba SouthRiver Medical Clinic aka: SouthRiver Community Health Center
- Federally Qualified Health Center (FQHC)
- Winston, OR
- NPI 1912061755
O20061121000327
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 38D1044591 | Adapt Integrated Health Care | Certificate of waiver | Mar 31, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Adapt
- Part of
- Adapt
Other organizations with this tax ID 20
Organizations that report the same tax identification number in the National Provider Directory.
-
- Addiction (Substance Use Disorder) Counselor
- Grants Pass, OR
- NPI 1144401043
-
- Addiction (Substance Use Disorder) Counselor
- Roseburg, OR
- NPI 1174952238
-
dba Adapt Integrated Health Care
- Federally Qualified Health Center (FQHC)
- Roseburg, OR
- NPI 1184350811
-
- Addiction (Substance Use Disorder) Counselor
- Reedsport, OR
- NPI 1235568155
-
- Adult Mental Health Clinic/Center
- Grants Pass, OR
- NPI 1477250603
-
- Addiction (Substance Use Disorder) Counselor
- Roseburg, OR
- NPI 1508295668
-
- Addiction (Substance Use Disorder) Counselor
- Roseburg, OR
- NPI 1639508708
-
- Substance Abuse Rehabilitation Facility
- Roseburg, OR
- NPI 1649453440
Locations
400 Virginia Ave
Ste 100
North Bend, OR 97459
Phone (541) 490-2022
400 Virginia Ave
Ste 201
North Bend, OR 97459
Phone (541) 492-0229
3005 NE Diamond Lake Blvd
Ste 150
Roseburg, OR 97470
Phone (541) 492-4550
406 NE Winchester St
Roseburg, OR 97470
Phone (541) 229-8934
92 NW Glenhart Ave
Winston, OR 97496
Phone (541) 492-4550
Ownership & related parties
All disclosed owners & managing parties 12
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| David S Rutter | Corporate Director | Sep 1, 2008 | |
| Todd C Munsey | Corporate Director | Jul 1, 2000 | |
| Dan Wilson | Corporate Director | Jun 1, 2019 | |
| Kelsey L Wood | Corporate Director | Mar 1, 2013 | |
| Jason Harmon | Corporate Director | Mar 1, 2022 | |
| Matt Brady | Corporate Director | Mar 1, 2022 | |
| Theresa M Lundy | Corporate Director | Jan 1, 2025 | |
| Susan Friedberger | Corporate Director | Mar 1, 2022 | |
| Michelle M Watson | Corporate Officer | Aug 26, 1996 | |
| Tiffani Parker | Corporate Director | Mar 1, 2022 | |
| Stephen Baron | Corporate Officer | Oct 6, 2025 | |
| Deborah Phillips | Corporate Director | Jun 1, 1998 | |
| W-2 Managing Employee | Jun 1, 1998 |
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Southriver Medical Clinic | Federally qualified health center | Operational/Managerial Control (100%) | Oct 28, 2009 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
dba SouthRiver Medical Clinic aka: SouthRiver Community Health Center
- Federally Qualified Health Center (FQHC)
- Winston, OR
- NPI 1912061755
Operational/Managerial Control
Practitioners & affiliated clinicians
Practitioners 101
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.
-
- Clinical Social Worker
- Brookings, OR
- NPI 1477232114
-
- Professional Counselor
- Roseburg, OR
- NPI 1760974364
-
- Mental Health Counselor
- Brookings, OR
- NPI 1184017444
-
- Professional Counselor
- Roseburg, OR
- NPI 1194116715
-
- Professional Counselor
- Roseburg, OR
- NPI 1982260113
-
- Hospitalist Physician
- Roseburg, OR
- NPI 1619990108
-
- Family Nurse Practitioner
- Bandon, OR
- NPI 1992133607
-
- Family Medicine Physician
- Roseburg, OR
- NPI 1598737033
-
- Clinical Social Worker
- Roseburg, OR
- NPI 1639703887
-
- Professional Counselor
- Roseburg, OR
- NPI 1598198954
-
- Family Nurse Practitioner
- Roseburg, OR
- NPI 1942034756
-
- Physician Assistant
- Roseburg, OR
- NPI 1538727839
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743465600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1792713600000",
"number": "1194529289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "621 W MADRONE ST",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "974703090",
"telephone_number": "541-492-0134",
"fax_number": "541-492-0134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 1ST ST SE STE 110",
"city": "BANDON",
"state": "OR",
"postal_code": "974119301",
"telephone_number": "541-672-2691",
"fax_number": "541-492-0190"
}
],
"practiceLocations": [
{
"address_1": "625 Pioneer Roard",
"address_purpose": "LOCATION",
"city": "Brookings",
"state": "OR",
"postal_code": "974158293",
"country_code": "US",
"telephone_number": "541-347-2529",
"fax_number": "541-492-0190",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "29516 Ellensburg Ave",
"address_purpose": "LOCATION",
"city": "Gold Beach",
"state": "OR",
"postal_code": "974448729",
"country_code": "US",
"telephone_number": "541-347-2529",
"fax_number": "541-490-0190",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1312 Tichenor St",
"address_purpose": "LOCATION",
"city": "Port Orford",
"state": "OR",
"postal_code": "974658776",
"country_code": "US",
"telephone_number": "541-347-2529",
"fax_number": "541-492-0190",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "ADAPT",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "ADAPT",
"enumeration_date": "2025-04-01",
"last_updated": "2026-10-23",
"certification_date": "2026-10-22",
"status": "A",
"authorized_official_last_name": "PHILLIPS",
"authorized_official_first_name": "DEBBIE",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
"authorized_official_telephone_number": "541-391-9071"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"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": "Adapt Integrated Health Care",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Bandon, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- 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.