NPIMap

Organization Active NPI

Good Shepherd Health Care System

Doing business as Good Shepherd Medical Center

  • Critical Access Hospital
  • Hermiston, OR
National Provider Identifier
1295789667
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
GOOD SHEPHERD HEALTH CARE SYSTEM
Doing business as
Good Shepherd Medical Center
Practice address
610 NW 11TH St
Hermiston, OR 97838-6601
Phone
(541) 667-3400
Fax
(541) 667-3715
NPI assigned
May 20, 2006
Last updated
Feb 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Authorized official

Name
Jonathan Edwards
Title
Coo & Cfo
Phone
(541) 667-3412

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X
Critical Access Hospital 282NC0060X OR Primary

Addresses

Primary practice location

610 NW 11TH St
Hermiston, OR 97838-6601

Mailing address

610 NW 11TH Street
Hermiston, OR 97838-9696
Phone (541) 667-3400

Other practice location 1

1050 W Elm Ave Ste 110
Hermiston, OR 97838-2713
Phone (541) 567-2995

Other identifiers 6

IdentifierTypeStateIssuer
008776MedicaidOR
7260409OtherWAWASHINGTON DSHS
0011096OtherWAWASHINGTON L & I
138002300OtherORBLUE CROSS
194609800OtherORUS DEPT OF LABOR
3001302OtherWAWASHINGTON DSHS

Other names 1

  • Good Shepherd Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20031118000046 OR Part B Supplier - Clinic/Group Practice 9133033764 Receives reassigned benefits from 349 practitioners
1 other NPI on this enrollment
Practice locations: Hermiston, OR
O20061104000537 OR Part A Provider - Critical Access Hospital 9133033764 Receives reassigned benefits from 179 practitioners
Practice locations: Hermiston, OR
O20071003000259 OR Part A Provider - Critical Access Hospital 9133033764 Receives reassigned benefits from 2 practitioners
Practice locations: Hermiston, OR

NPI to CCN mapping 3

The Medicare certification numbers (CCNs) connected to NPI 1295789667. Details of each certification follow.

Hospital certification: CCN 381325

Legal name
GOOD SHEPHERD HEALTH CARE SYSTEM
Doing business as
GOOD SHEPHERD MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Dec 29, 2005
Last certification
Nov 9, 2022
Beds
49 (25 certified)
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
May 8, 1953 in OR
Enrollment address
610 NW 11TH St
Hermiston, OR 97838-6601
Other Hospital Practice Location

Hospital certification: CCN 38Z325

Legal name
GOOD SHEPHERD HEALTH CARE SYSTEM
Doing business as
GOOD SHEPHERD MEDICAL CENTER
Organization structure
CorporationNon-profit
Incorporated
Jun 18, 1953 in OR
Enrollment address
610 NW 11TH St
Hermiston, OR 97838-6601
Other Hospital Practice Location

Hospital certification: CCN 380023

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
GOOD SHEPHERD MEDICAL CENTER
Certification status
Terminated Other: provider status change, Dec 28, 2005
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Oct 15, 1999
Beds
49
Ownership / control type
Private (not for profit)
Facility address
610 NW 11TH Street
Hermiston, OR 97838

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

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Good Shepherd Medical CenterCCN 381325 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member of 1

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

Locations

1500 E 2nd St
Ste 201
Reno, NV 89502
Phone (775) 348-7272

1050 W Elm Ave
Ste 150
Hermiston, OR 97838
Phone (541) 289-2060

435 NW 11th St
Hermiston, OR 97838
Phone (541) 667-3477

600 NW 11th St
Hermiston, OR 97838
Phone (509) 783-9894

600 NW 11th St
Ste E10
Hermiston, OR 97838
Phone (541) 667-2420

600 NW 11th St
Ste E12
Hermiston, OR 97838
Phone (541) 289-0440

600 NW 11th St
Ste E33
Hermiston, OR 97838
Phone (541) 667-3740

600 NW 11th St
Ste M103
Hermiston, OR 97838

610 NW 11th St
#19
Hermiston, OR 97838

610 NW 11th St
Ste E19
Hermiston, OR 97838
Phone (541) 667-3834

620 NW 11th St
#M103
Hermiston, OR 97838

620 NW 11th St
Ste 202
Hermiston, OR 97838
Phone (541) 667-3804

620 NW 11th St
Ste M102
Hermiston, OR 97838
Phone (541) 289-4120

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Jaclyn Jenkins Individual Corporate DirectorBoard Member Oct 23, 2023
Robert Longoria Individual Corporate DirectorBoard Member Oct 23, 2023
Carl Carlson Individual Corporate Director Sep 23, 2002
Arthur Mathisen Individual Corporate OfficerPresident/Ceo Jul 24, 2023 100%
Brian Patrick Individual Corporate OfficerVP of Nursing Sep 8, 2020
Susan Daggett Individual Corporate Director Sep 22, 2003
Arnell Eynon Individual Corporate Director Apr 23, 2015
Jon Lorence Individual Corporate Director Oct 1, 2020
Corporate DirectorBoard Member Oct 22, 2018
Nancy Mabry Individual Corporate Director Sep 23, 2002
Jonathan Edwards Individual Corporate OfficerCoo/Cfo Apr 7, 2008
W-2 Managing EmployeeRevenue Cycle Director Apr 7, 2008
W-2 Managing EmployeeCoo/Cfo Apr 1, 2008
Lisa Mittelsdorf Individual Corporate Director Sep 30, 2020
Corporate DirectorBoard Member Oct 28, 2019
Merle Steven Eldrige Individual Corporate Director Sep 11, 2003
Derek T. Earl Individual Corporate Director Sep 24, 2007
Kristen Coller Individual Corporate DirectorBoard Member Oct 24, 2022
Jeff Wenholz Individual Corporate Director Sep 30, 2020
Corporate DirectorBoard Member Oct 28, 2019

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 358

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.

View all 358

Affiliated clinicians 340

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

View all 340

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740355200000",
    "number": "1295789667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 NW 11TH STREET",
            "city": "HERMISTON",
            "state": "OR",
            "postal_code": "978389696",
            "telephone_number": "541-667-3400",
            "fax_number": "541-667-3715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 NW 11TH ST",
            "city": "HERMISTON",
            "state": "OR",
            "postal_code": "978386601",
            "telephone_number": "541-667-3400",
            "fax_number": "541-667-3715"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 W Elm Ave Ste 110",
            "address_purpose": "LOCATION",
            "city": "Hermiston",
            "state": "OR",
            "postal_code": "978382713",
            "country_code": "US",
            "telephone_number": "541-567-2995",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GOOD SHEPHERD HEALTH CARE SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "COO & CFO",
        "authorized_official_telephone_number": "541-667-3412"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008776",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON DSHS",
            "identifier": "7260409",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON L & I",
            "identifier": "0011096",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "138002300",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "194609800",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON DSHS",
            "identifier": "3001302",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Shepherd Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hermiston, OR

Sources for this page

Verify at the official NPI Registry.