NPIMap

Organization Active NPI

Coquille Valley Health

  • Family Medicine Physician
  • Coquille, OR
National Provider Identifier
1306785654
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COQUILLE VALLEY HEALTH
Practice address
790 E 5TH St Ste a
Coquille, OR 97423-1755
Phone
(541) 396-3111
Fax
(541) 824-1702
NPI assigned
Mar 25, 2026
Last updated
Mar 26, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

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

Authorized official

Name
Jeffrey Michael Lang
Title
Ceo
Phone
(541) 396-3101

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Orthopaedic Surgery Physician 207X00000X NU

Addresses

Primary practice location

790 E 5TH St Ste a
Coquille, OR 97423-1755

Mailing address

940 E 5TH St
Coquille, OR 97423-1666
Phone (541) 396-3101

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240910003766 OR Part B Supplier - Clinic/Group Practice 2567902182 Receives reassigned benefits from 21 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Coquille, OR; Coos Bay, OR; Myrtle Point, OR

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
Coquille Valley Health4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

790 E 5th St
Ste A
Coquille, OR 97423
Phone (541) 396-3111

Practitioners & affiliated clinicians

Practitioners 4

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": "1774396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774483200000",
    "number": "1306785654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 E 5TH ST",
            "city": "COQUILLE",
            "state": "OR",
            "postal_code": "974231666",
            "telephone_number": "541-396-3101",
            "fax_number": "541-824-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 E 5TH ST STE A",
            "city": "COQUILLE",
            "state": "OR",
            "postal_code": "974231755",
            "telephone_number": "541-396-3111",
            "fax_number": "541-824-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COQUILLE VALLEY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-25",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A",
        "authorized_official_last_name": "LANG",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-396-3101"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coquille, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2026; 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.