Good Shepherd Health Care System
Organization Active NPI Critical Access Hospital · Hermiston, OR
NPI 1295789667 · NPPES record last updated Feb 24, 2025
Key facts
- NPI
- 1295789667
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Access Hospital 282NC0060X
- Legal business name
- GOOD SHEPHERD HEALTH CARE SYSTEM
- Practice address
- 610 NW 11TH St
Hermiston, OR 97838-6601 - Phone
- (541) 667-3400
- Fax
- (541) 667-3715
- NPI assigned
- May 20, 2006
- Organization subpart
- No
Authorized official
- Name
- Jonathan Edwards
- Title
- Coo & Cfo
- Phone
- (541) 667-3412
Owners & managing parties with NPI records 1
-
Derek Ted Earl, D.O.
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 4
Member of 1
Related certifications (CCN) 1
Practitioners 361
-
Fadi Husayn Akoum, M.D.
-
Barbara L Atwood, MD LLC
-
Manmohan S Biring, M.D.
-
Kadi-Ann Bryan, MD
-
Daniel Scott Buck, M.D.
-
Charles N Buser, M.D.
-
Ivy M Cameron, APRN-NP
-
Donald J Carlson, DPM
-
Marcus Paul Carr, M.D.
-
Ashley Rae Christensen, ARNP
-
Linda Joan Cornwell, FNP-C
-
Taylor Jay Delamarter, D.O.
-
Chris Dinardo, PA
-
Kyle J Duncan, DPM
-
David Jean Duranceau, CRNA
-
John D Elliott, M.D.
-
Darren M Ernst, CRNA
-
Vivienne Ann Evans, A.R.N.P.
-
Richard Allan Flaiz, MD FACS
-
Peter Y Hahn, M.D.
Affiliated clinicians 340
-
Erika Acuna, PA-C
-
John Richard Adair, PA-C
-
Bradley Scott Adams, M.D.
-
Adam Z Ahmadi, MD
-
Fadi Husayn Akoum, M.D.
-
Seth Allen Alford, ARNP FNP-BC
-
Barbara L Atwood, MD LLC
-
Michelle Beam, MD, MPH
-
Cassidy Ann Berg, PA-C
-
Manmohan S Biring, M.D.
-
Simona S Braun, MD
-
Kadi-Ann Bryan, MD
-
Daniel Scott Buck, M.D.
-
Shaylyn Rhae Burnham, FNP-BC
-
Richard A Burt, MD
-
Charles N Buser, M.D.
-
Molly K Bushnell, PA-C
-
Ivy M Cameron, APRN-NP
Medicare Care Compare: Hospital
- Listed as
- Good Shepherd Medical Center
- Type
- Critical Access Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in OR
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
- Corporation · Non-profit
- Incorporated
- May 8, 1953 in OR
- Enrollment address
- 610 NW 11TH St
Hermiston, OR 97838-6601
Hospital certification: CCN 38Z325
- Legal name
- GOOD SHEPHERD HEALTH CARE SYSTEM
- Doing business as
- GOOD SHEPHERD MEDICAL CENTER
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jun 18, 1953 in OR
- Enrollment address
- 610 NW 11TH St
Hermiston, OR 97838-6601
All disclosed owners & managing parties 15
| Name | Role | Since | Share |
|---|---|---|---|
| Jaclyn Jenkins |
Corporate Director |
Oct 23, 2023 | |
| Robert Longoria |
Corporate Director |
Oct 23, 2023 | |
| Carl Carlson |
Corporate Director | Sep 23, 2002 | |
| Arthur Mathisen |
Corporate Officer |
Jul 24, 2023 | 100% |
| Brian Patrick |
Corporate Officer |
Sep 8, 2020 | |
| Susan Daggett |
Corporate Director | Sep 22, 2003 | |
| Arnell Eynon |
Corporate Director | Apr 23, 2015 | |
| Jon Lorence |
Corporate Director | Oct 1, 2020 | |
| Corporate Director |
Oct 22, 2018 | ||
| Nancy Mabry |
Corporate Director | Sep 23, 2002 | |
| Jonathan Edwards |
Corporate Officer |
Apr 7, 2008 | |
| W-2 Managing Employee |
Apr 7, 2008 | ||
| W-2 Managing Employee |
Apr 1, 2008 | ||
| Lisa Mittelsdorf |
Corporate Director | Sep 30, 2020 | |
| Corporate Director |
Oct 28, 2019 | ||
| Merle Steven Eldrige |
Corporate Director | Sep 11, 2003 | |
| Derek T. Earl |
Corporate Director | Sep 24, 2007 | |
| Kristen Coller |
Corporate Director |
Oct 24, 2022 | |
| Jeff Wenholz |
Corporate Director | Sep 30, 2020 | |
| Corporate Director |
Oct 28, 2019 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
Locations
620 NW 11th St
#M103
Hermiston, OR 97838
600 NW 11th St
Ste E33
Hermiston, OR 97838
Phone (541) 667-3740
620 NW 11th St
Ste 106
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
610 NW 11th St
#19
Hermiston, OR 97838
1050 W Elm Ave
Ste 110
Hermiston, OR 97838
Phone (541) 564-6411
600 NW 11th St
Ste E21
Hermiston, OR 97838
Phone (541) 567-2270
620 NW 11th St
#M106
Hermiston, OR 97838
610 NW 11th St
Ste E19
Hermiston, OR 97838
600 NW 11th St
Ste E12
Hermiston, OR 97838
Phone (541) 289-0440
600 NW 11th St
Ste M103
Hermiston, OR 97838
1050 W Elm Ave
Ste 150
Hermiston, OR 97838
Phone (541) 289-2060
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urgent Care Clinic/Center | 261QU0200X | |||
| Critical Access Hospital | 282NC0060X | OR | Yes |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3001302 | Other | WA | WASHINGTON DSHS |
| 008776 | Medicaid | OR | |
| 0011096 | Other | WA | WASHINGTON L & I |
| 138002300 | Other | OR | BLUE CROSS |
| 194609800 | Other | OR | US DEPT OF LABOR |
| 7260409 | Other | WA | WASHINGTON DSHS |
Other names
- Good Shepherd Medical Center
Other providers in Hermiston, OR
- Felicia Goff
- Roy Gomez
- Alejandro Sandoval Gonzalez Diaz
- Good Shepherd Health Care System
- Good Shepherd Health Care System
- Good Shepherd Health Care System
- Good Shepherd Health Care System
- Good Shepherd Health Care System
- Good Shepherd Health Care System
- Good Shepherd Health Care Systems
All providers in Hermiston, OR · Critical Access Hospital in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 24, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.