Santiam Memorial Hospital
Organization Active NPI Medicare Defined Swing Bed Hospital Unit · Stayton, OR
NPI 1336203124 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1336203124
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Medicare Defined Swing Bed Hospital Unit 275N00000X
- License
- 38U0056 (OR)
- Legal business name
- SANTIAM MEMORIAL HOSPITAL
- Practice address
- 1401 N 10TH Ave
Stayton, OR 97383-1311 - Phone
- (503) 769-9215
- Fax
- (503) 769-5312
- NPI assigned
- Dec 19, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Susan Brainard
- Title
- Director of Medical Records
- Phone
- (503) 769-9215
Owners & managing parties with NPI records 2
-
James W Bayuk, MD
-
Steven M Vets, DO
Other NPIs with the same Medicare PAC ID 7
Corporate family (same tax ID) 16
Related certifications (CCN) 2
Practitioners 128
-
Maxwell B Abbott, M.D.
-
Pedro Abdala, MD
-
Scott Harrison Ambruster, M.D.
-
Tasha Barkley, M. D. M.P.H.
-
Michael Bass, PA-C
-
John K Bradshaw, M.D.
-
Stephen Leon Burrows, M.D.
-
Ian Cavigli, PA-C
-
McKenna Chandler, PA-S
-
Michael C Chen, M.D.
-
Takahla Circle, APRN
-
Richard C Collins, M.D.
-
Sheila Marie Crispin, ACNPC-AG
-
Thomas Crum, DO
-
Thomas Cullen, M.D.
-
Kim Dang, MD
-
Fatima Janeth Dealy, PA-C
-
George M Degner, MD
-
Guesly Dessieux, DO
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
Hospital certification: CCN 38U056
- Legal name
- SANTIAM MEMORIAL HOSPITAL
- Organization structure
- Corporation · Non-profit
- Incorporated
- Oct 10, 1950 in OR
- Enrollment address
- 1401 N 10TH Ave
Stayton, OR 97383-1311 - Hospital subgroups
- Swing-bed approved
All disclosed owners & managing parties 16
| Name | Role | Since | Share |
|---|---|---|---|
| Melissa Baurer |
Corporate Officer |
Apr 1, 2025 | |
| Silvia Hernandez |
Corporate Director |
Feb 8, 2023 | 11.1% |
| Cassondra Posvar Martinez |
Corporate Officer |
Apr 1, 2025 | |
| W-2 Managing Employee |
Jan 1, 2021 | ||
| Ed Diehl |
Corporate Director |
Apr 12, 2017 | 11.1% |
| Rachael Seeder |
Corporate Officer |
Dec 1, 2020 | |
| Margaret a Hudson |
Corporate Officer |
Jan 25, 1993 | |
| W-2 Managing Employee |
Jan 25, 1993 | ||
| Mike L Odenthal |
Corporate Director |
Mar 11, 1979 | 11.1% |
| Pamela Ray |
Corporate Director |
Jun 12, 2019 | 11.1% |
| Steven M Vets |
Corporate Officer |
Jan 15, 2021 | |
| Tiffanie Pye |
Corporate Officer |
Oct 2, 2023 | |
| W-2 Managing Employee |
Oct 2, 2023 | ||
| James W Bayuk |
Corporate Director |
Feb 11, 2026 | 11.1% |
| Debbie Turrell |
Corporate Officer |
Apr 1, 2025 | |
| Genny Baldwin |
Corporate Director |
Jan 1, 2021 | 11.1% |
| Victor D Kintz |
Corporate Director |
May 12, 2003 | 11.1% |
| Maryann F Meredith |
Corporate Director |
Jun 9, 1998 | 11.1% |
| Emily Newton |
Corporate Director |
Feb 11, 2026 | 11.1% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070924000405 | OR | Part a Provider - Hospital | 6103729751 | Practice locations: Stayton, OR |
National Provider Directory
- Tax ID family
- Santaim Memorial Hospit
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medicare Defined Swing Bed Hospital Unit | 275N00000X | 38U0056 | OR | Yes |
Addresses
Primary practice location
1401 N 10TH Ave
Stayton, OR 97383-1311
Mailing address
1401 N 10TH Ave
Stayton, OR 97383-1311
Phone (503) 769-9215
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000120 | Medicaid | OR |
Other providers in Stayton, OR
- Santiam Memorial Hospital
- Santiam Memorial Hospital
- Santiam Memorial Hospital
- Santiam Memorial Hospital
- Santiam Memorial Hospital
- Santiam Memorial Hospital
- Santiam Memorial Hospital
- Santiam Memorial Hospital
- Santiam Memorial Hospital
- Santiam Memorial Hospital
All providers in Stayton, OR · Medicare Defined Swing Bed Hospital Unit in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.