NPIMap

Organization Active NPI

Mid-Columbia Medical Center

Doing business as Adventist Health Columbia Gorge

  • Home Health Agency
  • The Dalles, OR
National Provider Identifier
1205804101
Registry record updated Sep 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
13 140500 Issued in OR
Legal business name
MID-COLUMBIA MEDICAL CENTER
Doing business as
Adventist Health Columbia Gorge
Adventist Health Home Care
Practice address
1730 E 12TH St
The Dalles, OR 97058-3137
Phone
(541) 296-7280
NPI assigned
Mar 8, 2006
Last updated
Sep 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2026

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

Authorized official

Name
Kyle King
Title
Service Area President
Phone
(503) 261-4405

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 13 140500 OR Primary

Addresses

Primary practice location

1730 E 12TH St
The Dalles, OR 97058-3137

Mailing address

PO Box 1580
The Dalles, OR 97058-8004
Phone (541) 296-7280

Other identifiers 2

IdentifierTypeStateIssuer
132175MedicaidOR
9007204MedicaidWA

Other names 2

  • Adventist Health Columbia Gorge Doing business as
  • Adventist Health Home Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050707000719 OR Part A Provider - Home Health Agency 3779487251 Practice locations: The Dalles, OR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1205804101. Details of each certification follow.

Home health agency certification: CCN 387041

Legal name
MID-COLUMBIA MEDICAL CENTER
Doing business as
ADVENTIST HEALTH HOME CARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 1, 1978
Last certification
Jul 11, 2019
Ownership / control type
Non-Profit
Organization structure
CorporationNon-profit
Incorporated
Sep 20, 1984 in OR
Enrollment address
1730 E 12TH St
The Dalles, OR 97058-3137

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Adventist Health Home CareCCN 387041 · All quality measures
Overall star rating
2.5 of 5
Ownership
Non-Profit
Certified
May 1, 1978
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
The Dalles Family Pract6 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kyle a King Individual Corporate Director Apr 24, 2024
W-2 Managing Employee Apr 24, 2024
Kerry L Heinrich Individual Corporate OfficerPresident and Ceo Adventist Health Jun 19, 2023
Corporate DirectorPresident and Ceo Adventist Health Jun 1, 2023
W-2 Managing Employee Jun 1, 2023
Wendy H Apland Individual Corporate OfficerTreasurer Jun 2, 2023
Corporate Director Jun 2, 2023
W-2 Managing Employee Jun 2, 2023
Meredith S Jobe Individual Corporate OfficerChief Legal Officer Jun 1, 2023
Corporate DirectorChief Legal Officer Jun 1, 2023
W-2 Managing Employee Jun 1, 2023
Richard K Reiner Individual Corporate DirectorRetired Executive Board Member Jun 1, 2023
Todd N Hofheins Individual Corporate OfficerChief Financial Officer Jun 1, 2023
Corporate Director Jun 1, 2023
W-2 Managing Employee Jun 1, 2023
Stone Point Health Organization, Roseville, CA Corporation, Non-profit Operational/Managerial Control Jun 1, 2023
Larry L Innocent Individual Corporate DirectorPresident Pharmacy Board Member Jun 1, 2023

Facilities with the same owner 9

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 41

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789603200000",
    "number": "1205804101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1580",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970588004",
            "telephone_number": "541-296-7280",
            "fax_number": "541-296-7631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 E 12TH ST",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583137",
            "telephone_number": "541-296-7280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-COLUMBIA MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-08",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "SERVICE AREA PRESIDENT",
        "authorized_official_telephone_number": "503-261-4405"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OR",
            "license": "13 140500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132175",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9007204",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adventist Health Columbia Gorge",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Adventist Health Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in The Dalles, OR

Sources for this page

Verify at the official NPI Registry.