NPIMap

Organization Active NPI

Midv-Valley Healthcare, Inc.

  • Pediatrics Physician
  • Lebanon, OR
National Provider Identifier
1326304577
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
MIDV-VALLEY HEALTHCARE, INC.
Practice address
701 N 5TH St
Suite C-1020
Lebanon, OR 97355-9559
Phone
(541) 451-7820
NPI assigned
Apr 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

701 N 5TH St
Suite C-1020
Lebanon, OR 97355-9559

Mailing address

701 N 5TH St
Suite C-1020
Lebanon, OR 97355-9559
Phone (541) 451-7820

Other names 1

  • Mid-Valley Pediatrics Doing business as

Medicare participation

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

Enrollment records 1

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

Other NPIs on the same Medicare enrollment 27

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

View all 27

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1333324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333324800000",
    "number": "1326304577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 N 5TH ST",
            "address_2": "SUITE C-1020",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973559559",
            "telephone_number": "541-451-7820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N 5TH ST",
            "address_2": "SUITE C-1020",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973559559",
            "telephone_number": "541-451-7820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDV-VALLEY HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-02",
        "last_updated": "2012-04-02",
        "status": "A",
        "authorized_official_last_name": "PAPE",
        "authorized_official_first_name": "BECKY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-451-7107"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mid-Valley Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lebanon, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; 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.