NPIMap

Organization Active NPI

Silverton Health

  • Family Medicine Physician
  • Silverton, OR
National Provider Identifier
1306191044
Registry record updated Oct 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SILVERTON HEALTH
Practice address
347 Fairview St
Silverton, OR 97381
Phone
(503) 873-5667
Fax
(503) 873-5687
NPI assigned
Jul 18, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2016

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

Authorized official

Name
Linda Hoff
Title
Cfo
Phone
(503) 415-5730

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

347 Fairview St
Silverton, OR 97381

Mailing address

PO Box 4037
Portland, OR 97208
Phone (503) 873-1500

Other names 1

  • Legacy Medical Group Silverton Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040129000172 OR Part B Supplier - Clinic/Group Practice 8921901877 Receives reassigned benefits from 620 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Silverton, OR; Woodburn, OR; Salem, OR; Mount Angel, OR; Molalla, OR; Keizer, OR

Other NPIs on the same Medicare enrollment 14

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

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Carl R Olden17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Locations

454 Welch St
Silverton, OR 97381
Phone (503) 873-1722

Practitioners & affiliated clinicians

Practitioners 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476835200000",
    "number": "1306191044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4037",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97208",
            "telephone_number": "503-873-1500",
            "fax_number": "503-873-1534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 FAIRVIEW ST",
            "city": "SILVERTON",
            "state": "OR",
            "postal_code": "97381",
            "telephone_number": "503-873-5667",
            "fax_number": "503-873-5687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SILVERTON HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-18",
        "last_updated": "2016-10-19",
        "status": "A",
        "authorized_official_last_name": "HOFF",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "503-415-5730"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Medical Group Silverton",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Silverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; 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.