NPIMap

Organization Active NPI

Mid-Valley Healthcare, Inc

Doing business as Samaritan Kidney Specialists

  • Nephrology Physician
  • Lebanon, OR
National Provider Identifier
1366701344
Registry record updated May 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
MID-VALLEY HEALTHCARE, INC
Doing business as
Samaritan Kidney Specialists
Practice address
100 Mullins Dr
Suite B1
Lebanon, OR 97355-3982
Phone
(541) 768-6930
NPI assigned
May 10, 2012
Last updated
May 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2012

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

100 Mullins Dr
Suite B1
Lebanon, OR 97355-3982

Mailing address

100 Mullins Dr
Suite B1
Lebanon, OR 97355-3982
Phone (541) 768-6930

Other names 1

  • Samaritan Kidney Specialists 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": "1336608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336608000000",
    "number": "1366701344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MULLINS DR",
            "address_2": "SUITE B1",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973553982",
            "telephone_number": "541-768-6930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MULLINS DR",
            "address_2": "SUITE B1",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973553982",
            "telephone_number": "541-768-6930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-VALLEY HEALTHCARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-10",
        "last_updated": "2012-05-10",
        "status": "A",
        "authorized_official_last_name": "PAPE",
        "authorized_official_first_name": "BECKY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-451-7107"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Samaritan Kidney Specialists",
            "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 May 10, 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.