Peacehealth

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

13140711 Issued in OR

Legal business name

PEACEHEALTH

Practice address

2230 Kingwood St
Florence, OR 97439-9464

Phone

(541) 997-3418

Fax

(541) 902-6740

NPI assigned

Nov 8, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Richard Yecny

Title

Ceo

Phone

(541) 902-6050

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Peace Harbor Home Health Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Peacehealth

  • Community Based Hospice Care Agency
  • Ketchikan, AK
  • NPI 1386362580

  Member Of

  NPD member

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Peacehealth

  • Home Health Agency
  • Springfield, OR
  • NPI 1275524498

  Sold to, 2019-04-01

  CMS change of ownership

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408492800000",
    "number": "1225019011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 9TH ST",
            "city": "FLORENCE",
            "state": "OR",
            "postal_code": "974397398",
            "telephone_number": "541-997-3418",
            "fax_number": "541-902-6740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 KINGWOOD ST",
            "city": "FLORENCE",
            "state": "OR",
            "postal_code": "974399464",
            "telephone_number": "541-997-3418",
            "fax_number": "541-902-6740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACEHEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-08",
        "last_updated": "2014-08-20",
        "status": "A",
        "authorized_official_last_name": "YECNY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-902-6050",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OR",
            "license": "13140711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051516",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peace Harbor Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gregory Eugene Page, D.C.
• David Y Park, M.D.
• Justine E Parker, D.O.
• Deborah Lynn Pasternak, LMT
• Peacehealth
• Peacehealth
• Peacehealth
• Peacehealth
• Paul E. Pearson, M.D.
• Cameron Peddycord

• Home Health Agency in Florence, OR
• Providers in Florence, OR by specialty
• Home Health Agency in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.