NPIMap

Organization Active NPI

Santiam Memorial Hospital

Doing business as Damian E. Jorgensen M.D.

  • Primary Care Clinic/Center
  • Stayton, OR
National Provider Identifier
1427225192
Registry record updated May 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
SANTIAM MEMORIAL HOSPITAL
Doing business as
Damian E. Jorgensen M.D.
Practice address
1401 N 10TH Ave
Suite 200
Stayton, OR 97383-1311
Phone
(503) 769-9070
Fax
(503) 769-5416
NPI assigned
May 13, 2008
Last updated
May 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2008

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

Authorized official

Name
Mrs. Lynda M Fraser
Title
Clinic Coordinator
Phone
(503) 749-4734

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1401 N 10TH Ave
Suite 200
Stayton, OR 97383-1311

Mailing address

1401 N 10TH Ave
Suite 200
Stayton, OR 97383-1311
Phone (503) 769-9070

Other names 1

  • Damian E. Jorgensen M.D. Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040130000239 OR Part B Supplier - Clinic/Group Practice 6103729751 Receives reassigned benefits from 154 practitioners
22 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mill City, OR; Aumsville, OR; Sublimity, OR; Stayton, OR

Other NPIs on the same Medicare enrollment 22

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

View all 22

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210636800000",
    "number": "1427225192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 N 10TH AVE",
            "address_2": "SUITE 200",
            "city": "STAYTON",
            "state": "OR",
            "postal_code": "973831311",
            "telephone_number": "503-769-9070",
            "fax_number": "503-769-5416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 N 10TH AVE",
            "address_2": "SUITE 200",
            "city": "STAYTON",
            "state": "OR",
            "postal_code": "973831311",
            "telephone_number": "503-769-9070",
            "fax_number": "503-769-5416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTIAM MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-13",
        "last_updated": "2008-05-13",
        "status": "A",
        "authorized_official_last_name": "FRASER",
        "authorized_official_first_name": "LYNDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLINIC COORDINATOR",
        "authorized_official_telephone_number": "503-749-4734",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Damian E. Jorgensen M.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stayton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; 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.