NPIMap

Organization Active NPI

Providence Health Systems

  • PACE Provider Organization
  • Milwaukie, OR
National Provider Identifier
1437816659
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PACE Provider OrganizationTaxonomy code 251T00000X
Legal business name
PROVIDENCE HEALTH SYSTEMS
Practice address
10330 SE 32ND Ave Ste 110
Milwaukie, OR 97222-6596
Phone
(503) 717-3013
NPI assigned
Nov 22, 2021
Last updated
Nov 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Authorized official

Name
Holly Daigle
Title
RN CM
Phone
(503) 513-1300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PACE Provider Organization 251T00000X Primary

Addresses

Primary practice location

10330 SE 32ND Ave Ste 110
Milwaukie, OR 97222-6596

Mailing address

10330 SE 32ND Ave Ste 110
Milwaukie, OR 97222-6596
Phone (503) 717-3013

Other identifiers 1

IdentifierTypeStateIssuer
931146501MedicaidOR

Other names 1

  • PACE Program Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address holly.daigle@providence.org

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637539200000",
    "number": "1437816659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10330 SE 32ND AVE STE 110",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972226596",
            "telephone_number": "503-717-3013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10330 SE 32ND AVE STE 110",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972226596",
            "telephone_number": "503-717-3013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTH SYSTEMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-22",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A",
        "authorized_official_last_name": "DAIGLE",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "RN CM",
        "authorized_official_telephone_number": "503-513-1300"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "931146501",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "holly.daigle@providence.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "10330 SE 32nd Ave Ste 110",
            "city": "Milwaukie",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972226596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "PACE Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Milwaukie, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; 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.