NPIMap

Organization Active NPI

Santiam Memorial Hospital

Doing business as Santiam Infectious Diseases and Travel Medicine

  • Medical Specialty Clinic/Center
  • Stayton, OR
National Provider Identifier
1235706185
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
SANTIAM MEMORIAL HOSPITAL
Doing business as
Santiam Infectious Diseases and Travel Medicine
Practice address
1401 N 10TH Ave
Stayton, OR 97383-1311
Phone
(503) 769-9307
Fax
(503) 769-8692
NPI assigned
Jun 9, 2021
Last updated
Jun 9, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
SANTIAM MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Authorized official

Name
Lynda Fraser
Title
Medical Clinics Quality Coordinator
Phone
(503) 769-9254

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X NU Primary

Addresses

Primary practice location

1401 N 10TH Ave
Stayton, OR 97383-1311

Mailing address

1401 N 10TH Ave
Stayton, OR 97383-1311

Other names 1

  • Santiam Infectious Diseases and Travel Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040130000239 OR Part B Supplier - Clinic/Group Practice 6103729751 Receives reassigned benefits from 154 practitioners
22 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mill City, OR; Aumsville, OR; Sublimity, OR; Stayton, OR

Other NPIs on the same Medicare enrollment 22

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 22

National Provider Directory

National Provider Directory
Part of
Santaim Memorial Hospit

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1623196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623196800000",
    "number": "1235706185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 N 10TH AVE",
            "city": "STAYTON",
            "state": "OR",
            "postal_code": "973831311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 N 10TH AVE",
            "city": "STAYTON",
            "state": "OR",
            "postal_code": "973831311",
            "telephone_number": "503-769-9307",
            "fax_number": "503-769-8692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTIAM MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SANTIAM MEMORIAL HOSPITAL",
        "enumeration_date": "2021-06-09",
        "last_updated": "2021-06-09",
        "certification_date": "2021-05-24",
        "status": "A",
        "authorized_official_last_name": "FRASER",
        "authorized_official_first_name": "LYNDA",
        "authorized_official_title_or_position": "MEDICAL CLINICS QUALITY COORDINATOR",
        "authorized_official_telephone_number": "503-769-9254"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Santiam Infectious Diseases and Travel Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stayton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.