NPIMap

Organization Active NPI

County of Tillamook

Doing business as Tillamook County Health Department - Mobile Clinic

  • Federally Qualified Health Center (FQHC)
  • Tillamook, OR
National Provider Identifier
1427603968
Registry record updated Sep 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COUNTY OF TILLAMOOK
Doing business as
Tillamook County Health Department - Mobile Clinic
Practice address
1925 Suppress Rd N
Tillamook, OR 97141-9296
Phone
(503) 842-3900
Fax
(503) 842-3903
NPI assigned
Aug 1, 2019
Last updated
Sep 23, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2019

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

Authorized official

Name
Marlene L Putman
Title
Administrator
Phone
(503) 842-3922

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1925 Suppress Rd N
Tillamook, OR 97141-9296

Mailing address

PO Box 489
Tillamook, OR 97141-0489
Phone (503) 842-3900

Other identifiers 1

IdentifierTypeStateIssuer
128756MedicaidOR

Other names 1

  • Tillamook County Health Department - Mobile Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040413000702 OR Part B Supplier - Clinic/Group Practice 3173411287 Receives reassigned benefits from 10 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cloverdale, OR; Rockaway Beach, OR; Tillamook, OR

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Tax ID family
County of Tillamook6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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": "1564617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569196800000",
    "number": "1427603968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 489",
            "city": "TILLAMOOK",
            "state": "OR",
            "postal_code": "971410489",
            "telephone_number": "503-842-3900",
            "fax_number": "503-842-3903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 SUPPRESS RD N",
            "city": "TILLAMOOK",
            "state": "OR",
            "postal_code": "971419296",
            "telephone_number": "503-842-3900",
            "fax_number": "503-842-3903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF TILLAMOOK",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-01",
        "last_updated": "2019-09-23",
        "status": "A",
        "authorized_official_last_name": "PUTMAN",
        "authorized_official_first_name": "MARLENE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "503-842-3922"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128756",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tillamook County Health Department - Mobile Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tillamook County Health Department - Mobile Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tillamook, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; 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.