NPIMap

Organization Active NPI

Grande Ronde Hospital, Inc.

  • Critical Access Hospital
  • La Grande, OR
National Provider Identifier
1467446195
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
140728 Issued in OR
Legal business name
GRANDE RONDE HOSPITAL, INC.
Practice address
900 Sunset Dr
La Grande, OR 97850-3290
Phone
(541) 963-1472
Fax
(541) 963-1862
NPI assigned
Sep 8, 2005
Last updated
Oct 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Authorized official

Name
Jeremy P Davis
Title
President/Ceo
Phone
(541) 963-8421

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Multi-Specialty Clinic/Center 261QM1300X
Physical Therapy Clinic/Center 261QP2000X
Primary Care Clinic/Center 261QP2300X
Sleep Disorder Diagnostic Clinic/Center 261QS1200X
Urgent Care Clinic/Center 261QU0200X
Critical Access Hospital 282NC0060X 140728 OR Primary
Critical Access Hospital 282NC0060X

Addresses

Primary practice location

900 Sunset Dr
La Grande, OR 97850-3290

Mailing address

PO Box 3290
La Grande, OR 97850-7290
Phone (541) 963-8421

Other practice location 1

10303 S Walton Rd
LA Grande, OR 97850-9413
Phone (541) 962-7845

Other practice location 2

710 Sunset Dr Ste E
LA Grande, OR 97850-1200
Phone (541) 663-3150

Other practice location 3

700 Sunset Dr Ste C
LA Grande, OR 97850-1260
Phone (541) 663-3135

Other practice location 4

700 Sunset Dr Ste F
LA Grande, OR 97850-1260
Phone (541) 663-3030

Other practice location 5

700 Sunset Dr Ste A
LA Grande, OR 97850-1260
Phone (541) 963-1919

Other practice location 6

710 Sunset Dr Ste F
LA Grande, OR 97850-1200
Phone (541) 663-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20031124000758 OR Part B Supplier - Clinic/Group Practice 0547170789 Receives reassigned benefits from 163 practitioners
5 other NPIs on this enrollment
Practice locations: La Grande, OR
O20061104000155 OR Part A Provider - Critical Access Hospital 0547170789 Receives reassigned benefits from 154 practitioners
4 other NPIs on this enrollment
Practice locations: La Grande, OR
O20071003000388 OR Part A Provider - Critical Access Hospital 0547170789 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: La Grande, OR

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1467446195. Details of each certification follow.

Hospital certification: CCN 381321

Legal name
GRANDE RONDE HOSPITAL INC
Doing business as
GRANDE RONDE HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Aug 1, 2004
Last certification
Apr 5, 2013
Beds
49 (25 certified)
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1986 in OR
Enrollment address
900 Sunset Dr
La Grande, OR 97850-1387
Main/Primary Hospital Location

Hospital certification: CCN 38Z321

Legal name
GRANDE RONDE HOSPITAL INC
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1986 in OR
Enrollment address
900 Sunset Dr
La Grande, OR 97850-1387
Other Hospital Practice Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 5

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Grande Ronde HospitalCCN 381321 · All quality measures
Overall star rating
5 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D2185620Grande Ronde Hospital Dermatology700 Sunset Dr, Suite F, La Grande, OR 97850Certificate of waiverJun 4, 2028

National Provider Directory

National Provider Directory

Locations

612 Sunset Dr
La Grande, OR 97850
Phone (541) 663-3150

700 Sunset Dr
Ste F
La Grande, OR 97850
Phone (541) 663-3030

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Stephen M McLean Individual Corporate Director Jan 1, 2016
Samuel H Kimball Individual Corporate Director Feb 22, 2017
Michael a Hetrick Individual Corporate Director Jan 1, 2016
Suzanne D Hopper Individual Corporate Director Jan 1, 2015
Blake a Gornowicz Individual Corporate Director Jan 1, 2022
Robert P Seymour Individual W-2 Managing Employee Jan 1, 2017
W-2 Managing Employee Dec 30, 2016
Lara Kay Moore Individual Corporate Director Nov 16, 2016
John Garlitz Individual Corporate Director Jan 1, 2016
Nicholas Alvin Huelter Individual Corporate Director Jan 1, 2021
Jeremy P Davis Individual Corporate OfficerCeo Nov 26, 2018
Corporate OfficerPresident/Ceo Nov 26, 2018
W-2 Managing EmployeePresident/Ceo Nov 26, 2018
Teri S Champlin Individual Corporate Director Jan 1, 2014
Jared Cole Rogers Individual Corporate Director Dec 24, 2019
Robert Coulter Individual Corporate Director Jan 1, 2021
Michael E Billman Individual Corporate Director Jan 1, 2019
Grande Ronde Hospital Inc Organization, La Grande, OR Corporation Operational/Managerial Control May 31, 1966
Stacy Whitaker Individual Corporate Director Jan 1, 2018
Bradley D Trisler Individual Corporate Director Jan 1, 2010
Carla M Hagen Individual Corporate Director Feb 22, 2017
Floyd S Lyon Individual Corporate Director Jan 1, 2009
Libby H Goben Individual Corporate Director Jan 1, 2008

Owners & managing parties with NPI records 11

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Grande Ronde Hospital IncLa Grande, OR, CCN 38Z321 Hospital Operational/Managerial Control May 31, 1966
Grande Ronde Hospital Regional Medical ClinicLa Grande, OR, CCN 388527 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2005
Grande Ronde Hospital Women's & Children's ClinicLa Grande, OR, CCN 388525 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Nov 1, 1996
Grande Ronde Hospital Union ClinicUnion, OR, CCN 388526 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2005
Grande Ronde Hospital Elgin ClinicElgin, OR, CCN 388524 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2005
Grande Ronde Hospital Urgent CareLa Grande, OR, CCN 388549 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Sep 14, 2020

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 169

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 169

Affiliated clinicians 219

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 219

NPI Registry JSON

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761264000000",
    "number": "1467446195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3290",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978507290",
            "telephone_number": "541-963-8421",
            "fax_number": "541-963-1845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 SUNSET DR",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978503290",
            "telephone_number": "541-963-1472",
            "fax_number": "541-963-1862"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10303 S Walton Rd",
            "address_purpose": "LOCATION",
            "city": "LA Grande",
            "state": "OR",
            "postal_code": "978509413",
            "country_code": "US",
            "telephone_number": "541-962-7845",
            "fax_number": "541-975-5225",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "710 Sunset Dr Ste E",
            "address_purpose": "LOCATION",
            "city": "LA Grande",
            "state": "OR",
            "postal_code": "978501200",
            "country_code": "US",
            "telephone_number": "541-663-3150",
            "fax_number": "541-975-5111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 Sunset Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "LA Grande",
            "state": "OR",
            "postal_code": "978501260",
            "country_code": "US",
            "telephone_number": "541-663-3135",
            "fax_number": "541-975-5104",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 Sunset Dr Ste F",
            "address_purpose": "LOCATION",
            "city": "LA Grande",
            "state": "OR",
            "postal_code": "978501260",
            "country_code": "US",
            "telephone_number": "541-663-3030",
            "fax_number": "541-975-5201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 Sunset Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "LA Grande",
            "state": "OR",
            "postal_code": "978501260",
            "country_code": "US",
            "telephone_number": "541-963-1919",
            "fax_number": "541-975-5240",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "710 Sunset Dr Ste F",
            "address_purpose": "LOCATION",
            "city": "LA Grande",
            "state": "OR",
            "postal_code": "978501200",
            "country_code": "US",
            "telephone_number": "541-663-3100",
            "fax_number": "541-975-5135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GRANDE RONDE HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-08",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "541-963-8421"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "OR",
            "license": "140728",
            "primary": true
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grande, OR

Sources for this page

Verify at the official NPI Registry.