Oak Street Health Care Center P C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

OAK STREET HEALTH CARE CENTER P C

Practice address

446 Oak St
Brookings, OR 97415-9612

Phone

(541) 412-8898

Fax

(541) 412-7420

NPI assigned

Jun 3, 2006

Organization subpart

No

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

Authorized official

Name

Lee M Wilson

Title

Administrator

Phone

(541) 469-6023

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR2 enrollments

Enrollment records 2

Rural health clinic certification: CCN 383839

Legal name

OAK STREET HEALTH CARE CENTER P C

Doing business as

OAK STREET HEALTH CARE CENTER

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Sep 21, 2001

Last certification

Feb 4, 2025

Ownership / control type

1A

Organization structure

CorporationProprietary

Incorporated

Mar 22, 2001 in OR

Enrollment address

446 Oak St
Brookings, OR 97415-9612

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

CLIA laboratory certificates

All disclosed owners & managing parties 2

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

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Mark Edward Silver, MD

  • Ambulatory Family Planning Facility
  • Brookings, OR
  • NPI 1639178114

  5% Or Greater Direct Ownership Interest, Corporate Director

  CMS ownership

Practitioners 4

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

• Debbra Lynn Forrester, FNP

  • Family Nurse Practitioner
  • Baker City, OR
  • NPI 1134708753
  Medicare reassignment Care Compare group NPD
• Margaret Ann Gressle, ACNP-BC

  • Acute Care Nurse Practitioner
  • Port Huron, MI
  • NPI 1003119132

  OR

  Medicare reassignment Care Compare group NPD
• Heidi Jo Carlson, FNP

  • Nurse Practitioner
  • Brookings, OR
  • NPI 1912906470
  Medicare reassignment Care Compare group
• Cheryl L Malo-Clines, NP

  • Family Nurse Practitioner
  • Brookings, OR
  • NPI 1790994697
  Medicare reassignment NPD

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264118400000",
    "number": "1235177288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6579",
            "city": "BROOKINGS",
            "state": "OR",
            "postal_code": "974150285",
            "telephone_number": "541-412-8898",
            "fax_number": "541-412-7420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 OAK ST",
            "city": "BROOKINGS",
            "state": "OR",
            "postal_code": "974159612",
            "telephone_number": "541-412-8898",
            "fax_number": "541-412-7420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK STREET HEALTH CARE CENTER P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2010-01-22",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "541-469-6023"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "228756",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jolene Lynn Nida
• Joshua Matthew Nielsen
• Amanda Rachelle Noble, PHARM D
• James Thomas Norland, MD
• Northland Hearing Centers, Inc.
• Ashleigh Ocacio
• Ocean Park
• Ocean Park Memory Care
• Nicholas Ochoa
• Rachel Ochoa

• Family Medicine Physician in Brookings, OR
• Providers in Brookings, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2010; 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.

Verify at the official NPI Registry.