NPIMap

Organization Active NPI

Santiam Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Stayton, OR
National Provider Identifier
1336203124
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
38U0056 Issued in 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
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Susan Brainard
Title
Director of Medical Records
Phone
(503) 769-9215

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 38U0056 OR Primary

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070924000405 OR Part A Provider - Hospital 6103729751 Practice locations: Stayton, OR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1336203124. Details of each certification follow.

Hospital certification: CCN 38U056

Legal name
SANTIAM MEMORIAL HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Oct 10, 1950 in OR
Enrollment address
1401 N 10TH Ave
Stayton, OR 97383-1311
Hospital Swing-Bed Unit
Hospital subgroups
Swing-bed approved

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Scott Boren17 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

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Melissa Baurer Individual Corporate OfficerExec Director Community Development Apr 1, 2025
Silvia Hernandez Individual Corporate DirectorBoard Member Feb 8, 2023 11.1%
Cassondra Posvar Martinez Individual Corporate OfficerExec Director Revenue&Reimbursement Apr 1, 2025
W-2 Managing EmployeeExec Director Revenue&Reimbursement Jan 1, 2021
Ed Diehl Individual Corporate DirectorBoard Member Apr 12, 2017 11.1%
Rachael Seeder Individual Corporate OfficerDirector of Finance Dec 1, 2020
Margaret a Hudson Individual Corporate OfficerCeo Jan 25, 1993
W-2 Managing EmployeeCeo Jan 25, 1993
Mike L Odenthal Individual Corporate DirectorBoard Member Mar 11, 1979 11.1%
Pamela Ray Individual Corporate DirectorBoard Member Jun 12, 2019 11.1%
Steven M Vets Individual Corporate OfficerCmo Jan 15, 2021
Tiffanie Pye Individual Corporate OfficerCoo Oct 2, 2023
W-2 Managing EmployeeCoo Oct 2, 2023
James W Bayuk Individual Corporate DirectorBoard Member Feb 11, 2026 11.1%
Debbie Turrell Individual Corporate OfficerCno Apr 1, 2025
Genny Baldwin Individual Corporate DirectorBoard Member Jan 1, 2021 11.1%
Victor D Kintz Individual Corporate DirectorBoard Member May 12, 2003 11.1%
Maryann F Meredith Individual Corporate DirectorBoard Member Jun 9, 1998 11.1%
Emily Newton Individual Corporate DirectorBoard Member Feb 11, 2026 11.1%

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336203124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 N 10TH AVE",
            "city": "STAYTON",
            "state": "OR",
            "postal_code": "973831311",
            "telephone_number": "503-769-9215",
            "fax_number": "503-769-5312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 N 10TH AVE",
            "city": "STAYTON",
            "state": "OR",
            "postal_code": "973831311",
            "telephone_number": "503-769-9215",
            "fax_number": "503-769-5312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTIAM MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRAINARD",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "DIRECTOR OF MEDICAL RECORDS",
        "authorized_official_telephone_number": "503-769-9215",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "OR",
            "license": "38U0056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stayton, OR

Sources for this page

Verify at the official NPI Registry.