NPIMap

Organization Active NPI

Mid-Valley Healthcare, Inc.

Doing business as Samaritan Urology- Lebanon

  • Urology Physician
  • Lebanon, OR
National Provider Identifier
1245595180
Registry record updated Feb 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
MID-VALLEY HEALTHCARE, INC.
Doing business as
Samaritan Urology- Lebanon
Practice address
425 N Santiam Hwy
Suite 2a
Lebanon, OR 97355-4361
Phone
(541) 812-5820
Fax
(541) 812-5821
NPI assigned
Jul 6, 2012
Last updated
Feb 5, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2013

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

Authorized official

Name
Becky Pape
Title
Ceo
Phone
(541) 451-7107

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

425 N Santiam Hwy
Suite 2a
Lebanon, OR 97355-4361

Mailing address

425 N Santiam Hwy
Suite 2a
Lebanon, OR 97355-4361
Phone (541) 812-5820

Other names 1

  • Samaritan Urology- Lebanon Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031111000297 OR Part B Supplier - Clinic/Group Practice 2769391523 Receives reassigned benefits from 458 practitioners
27 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lebanon, OR; Sweet Home, OR; Newport, OR; Halsey, OR; Brownsville, OR
O20061104000140 OR Part A Provider - Critical Access Hospital 2769391523 Receives reassigned benefits from 421 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lebanon, OR; Sweet Home, OR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245595180. Details of each certification follow.

Hospital certification: CCN 381323

Legal name
MID-VALLEY HEALTHCARE INC
Doing business as
SAMARITAN LEBANON COMMUNITY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jun 1, 2005
Last certification
Jun 8, 2006
Beds
49 (25 certified)
Ownership / control type
Church
Organization structure
CorporationNon-profit
Incorporated
Jun 5, 1950 in OR
Enrollment address
525 N Santiam Hwy
Lebanon, OR 97355-4363
Other Hospital Practice Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 29

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

View all 29

Care Compare: Hospital

Medicare Care Compare
Listed as
Samaritan Lebanon Community HospitalCCN 381323 · All quality measures
Overall star rating
3 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

425 N Santiam Hwy
Ste 2A
Lebanon, OR 97355
Phone (541) 812-5820

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Robert Adams Individual Corporate DirectorSecretary Jan 1, 2016
Rachel Hankins Individual Corporate DirectorBoard Member Oct 9, 2018
Samaritan Health Services Inc. Organization, Corvallis, OR Non-profit Operational/Managerial Control Jan 1, 1997 100%
Richard C Evans Individual Corporate DirectorGM Chair Jan 1, 2021
Marsha Philpott Individual Corporate DirectorBoard Member Jan 1, 2015
Mirabelle Fernandes Paul Individual Corporate DirectorBoard Member Jan 1, 2025
Loren Roth Individual Corporate DirectorTreasurer Jan 1, 2015
Joseph Cahill Individual Corporate OfficerCeo Dec 15, 2015 100%
W-2 Managing Employee Dec 15, 2015
Andrew Wimer Individual Corporate DirectorBoard Member Jun 25, 2024
Vanessa R Papalazaros Individual Corporate Director Jan 1, 2025
Wendie Wunderwald Individual Corporate DirectorBoard Member Jan 1, 2025
Jennifer Kimberlain Individual Corporate OfficerCeo/Administrator - SLCH Mar 9, 2026
W-2 Managing EmployeeAd; Mar 9, 2026
Operational/Managerial ControlCeo/Administrator - SLCH Mar 9, 2026
Richard C Wopat Individual Corporate DirectorBoard Member Jan 1, 2021
Linn Armstrong Individual Corporate DirectorBoard Member Jan 1, 2016
Randy Springer Individual Corporate DirectorPresident Jan 1, 2017
Brent Kauffman Individual Corporate DirectorBoard Member Jan 1, 2017
Paula M Crone Individual Corporate DirectorBoard Member Dec 11, 2018
Daniel Burton Smith Individual Corporate OfficerVice President Finance/Cfo Apr 24, 2003

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Affiliated clinicians 430

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

View all 430

NPI Registry JSON

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

{
    "created_epoch": "1341532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360022400000",
    "number": "1245595180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 N SANTIAM HWY",
            "address_2": "SUITE 2A",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973554361",
            "telephone_number": "541-812-5820",
            "fax_number": "541-812-5821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 N SANTIAM HWY",
            "address_2": "SUITE 2A",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973554361",
            "telephone_number": "541-812-5820",
            "fax_number": "541-812-5821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-VALLEY HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-06",
        "last_updated": "2013-02-05",
        "status": "A",
        "authorized_official_last_name": "PAPE",
        "authorized_official_first_name": "BECKY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-451-7107"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Samaritan Urology- Lebanon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lebanon, OR

Sources for this page

Verify at the official NPI Registry.