NPIMap

Organization Active NPI

One Community Health

  • Federally Qualified Health Center (FQHC)
  • White Salmon, WA
National Provider Identifier
1376221259
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ONE COMMUNITY HEALTH
Practice address
65371 Highway 14
White Salmon, WA 98672-8690
Phone
(509) 493-2133
NPI assigned
Jul 10, 2023
Last updated
Jul 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Authorized official

Name
Jennifer Griffith
Title
Chief People Officer
Phone
(541) 256-4406

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Migrant Health Clinic/Center 261QM1000X NU

Addresses

Primary practice location

65371 Highway 14
White Salmon, WA 98672-8690

Mailing address

849 Pacific Ave
Hood River, OR 97031-1956
Phone (541) 386-6380

Other identifiers 2

IdentifierTypeStateIssuer
022876MedicaidOR
1033269204MedicaidOR

Other names 1

  • One Community Health Northshore Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20231218000903 WA Part A Provider - Federally Qualified Health Center (FQHC) 6305759283 Practice locations: White Salmon, WA
O20240222000329 WA Part B Supplier - Clinic/Group Practice 6305759283 Receives reassigned benefits from 23 practitioners
1 other NPI on this enrollment
Practice locations: Stevenson, WA; White Salmon, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376221259. Details of each certification follow.

Federally qualified health center certification: CCN 501043

Legal name
ONE COMMUNITY HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 1, 2024
Last certification
Jan 1, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 8, 1986 in OR
Enrollment address
65371 Highway 14
White Salmon, WA 98672-8690

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Shawn Whalen Individual Corporate DirectorBoard Member Jul 1, 2013
Shannon Saldivar Individual Corporate DirectorBoard Member Feb 1, 2015
Renerose Hinkle Individual Corporate OfficerChief Financial Officer Aug 22, 2022
Corporate DirectorCfo Aug 22, 2022
Operational/Managerial ControlCfo Aug 22, 2022
Maxamillian Janasik Individual Corporate OfficerCeo Aug 5, 2019
Corporate DirectorCeo Aug 5, 2019
W-2 Managing EmployeeCeo Aug 5, 2019
Amy Klee Individual Corporate DirectorBoard Member Jun 1, 2010
Ian Chandler Individual Corporate DirectorBoard Member Mar 1, 2015

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688947200000",
    "number": "1376221259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "849 PACIFIC AVE",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970311956",
            "telephone_number": "541-386-6380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65371 HIGHWAY 14",
            "city": "WHITE SALMON",
            "state": "WA",
            "postal_code": "986728690",
            "telephone_number": "509-493-2133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONE COMMUNITY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A",
        "authorized_official_last_name": "GRIFFITH",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CHIEF PEOPLE OFFICER",
        "authorized_official_telephone_number": "541-256-4406"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Migrant Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022876",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033269204",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "One Community Health Northshore",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in White Salmon, WA

Sources for this page

Verify at the official NPI Registry.