NPIMap

Organization Active NPI

Confederated Tribes of the Warm Springs Reservation of Oregon

  • Federal Public Health Clinic/Center
  • Warm Springs, OR
National Provider Identifier
1336440502
Registry record updated Jan 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federal Public Health Clinic/CenterTaxonomy code 261QP0904X
License
26 Issued in OR
Legal business name
CONFEDERATED TRIBES OF THE WARM SPRINGS RESERVATION OF OREGON
Practice address
1270 Kot Num Rd
Warm Springs, OR 97761
Phone
(541) 553-1196
NPI assigned
Nov 4, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2022

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

Authorized official

Name
Michael Joseph Collins
Title
Director of Managed Care
Phone
(541) 553-4948

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federal Public Health Clinic/Center 261QP0904X 26 OR Primary

Addresses

Primary practice location

1270 Kot Num Rd
Warm Springs, OR 97761

Mailing address

1270 Kotnum Rd
Warm Springs, OR 97761
Phone (541) 553-1196

Other identifiers 1

IdentifierTypeStateIssuer
164964MedicaidOR

National Provider Directory

National Provider Directory
Tax ID family
Confederated Tribes of the Warm Springs Reservation of Oregon4 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.

NPI Registry JSON

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

{
    "created_epoch": "1288828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643587200000",
    "number": "1336440502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1270 KOTNUM RD",
            "city": "WARM SPRINGS",
            "state": "OR",
            "postal_code": "97761",
            "telephone_number": "541-553-1196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 KOT NUM RD",
            "city": "WARM SPRINGS",
            "state": "OR",
            "postal_code": "97761",
            "telephone_number": "541-553-1196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONFEDERATED TRIBES OF THE WARM SPRINGS RESERVATION OF OREGON",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-04",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "DIRECTOR OF MANAGED CARE",
        "authorized_official_telephone_number": "541-553-4948"
    },
    "taxonomies": [
        {
            "code": "261QP0904X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, Federal",
            "state": "OR",
            "license": "26",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164964",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warm Springs, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.