Grande Ronde Hospital, Inc.
Organization Active NPI Critical Access Hospital · La Grande, OR
NPI 1467446195 · NPPES record last updated Oct 24, 2025
Key facts
- NPI
- 1467446195
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Access Hospital 282NC0060X
- License
- 140728 (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
- Organization subpart
- No
Authorized official
- Name
- Jeremy P Davis
- Title
- President/Ceo
- Phone
- (541) 963-8421
Owners & managing parties with NPI records 11
-
Blake Gornowicz, MD
-
Stephen McLean, DMD
Owned or controlled facilities with NPI records 6
Other NPIs on the same Medicare enrollment 5
Other NPIs with the same Medicare PAC ID 7
Related certifications (CCN) 9
Practitioners 171
-
Maricela Elena Bandel-Ramirez, AGACNP
-
Andrew Dale Baum, DPM
-
Raffaella Sappe Betza, M.D.
-
Debora Brown-Cumpton, LCSW
-
Marcus Paul Carr, M.D.
-
Bradley Robert Close, CRNA
-
Aaron Randy Cooper, PA-C
-
Brooke Davis, DO
-
Gerry F Funk, MD
-
Geraldine Gardner, D.O.
-
Ellen Faye Hills, NP
-
Heather Holland, MSW, LCSW
-
Jared Johnathan Hulme, APRN, DNP, FNP-C
-
Leslie W Jackson, MD
-
Zachary Michael Jacobsen, CRNA
-
Jesse Jarnes, CRNA
-
John Karlin, ARNP
-
Rodrigo R Lim, M.D.
Affiliated clinicians 219
-
Jacquelyn Denise Adams, DNP, FNP
-
Fadi Husayn Akoum, M.D.
-
Monte W. Anderson, PA-C
-
Kylie Andrews, PA
-
Weston Baker, MD
-
Maricela Elena Bandel-Ramirez, AGACNP
-
Tempie Bartell, FNP-C
-
Andrew Dale Baum, DPM
-
Raffaella Sappe Betza, M.D.
-
Manmohan S Biring, M.D.
-
Heather R Brock, ARNP
-
Marcus Paul Carr, M.D.
-
Neil J Carroll, MD
-
Bradley Robert Close, CRNA
-
Bryan Richard Conklin, MD PC
-
Kerma Luann Cook, ANP
-
Aaron Randy Cooper, PA-C
-
Brooke Davis, DO
Medicare Care Compare: Hospital
- Listed as
- Grande Ronde Hospital
- Overall star rating
- ★★★★★ 5 of 5
- Type
- Critical Access Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 38D2185620 | Grande Ronde Hospital Dermatology | Certificate of waiver | Jun 4, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in OR
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
- Corporation · Non-profit
- Incorporated
- Jan 1, 1986 in OR
- Enrollment address
- 900 Sunset Dr
La Grande, OR 97850-1387
Hospital certification: CCN 38Z321
- Legal name
- GRANDE RONDE HOSPITAL INC
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jan 1, 1986 in OR
- Enrollment address
- 900 Sunset Dr
La Grande, OR 97850-1387
All disclosed owners & managing parties 20
| Name | Role | Since | Share |
|---|---|---|---|
| Stephen M McLean |
Corporate Director | Jan 1, 2016 | |
| Samuel H Kimball |
Corporate Director | Feb 22, 2017 | |
| Michael a Hetrick |
Corporate Director | Jan 1, 2016 | |
| Suzanne D Hopper |
Corporate Director | Jan 1, 2015 | |
| Blake a Gornowicz |
Corporate Director | Jan 1, 2022 | |
| Robert P Seymour |
W-2 Managing Employee | Jan 1, 2017 | |
| W-2 Managing Employee | Dec 30, 2016 | ||
| Lara Kay Moore |
Corporate Director | Nov 16, 2016 | |
| John Garlitz |
Corporate Director | Jan 1, 2016 | |
| Nicholas Alvin Huelter |
Corporate Director | Jan 1, 2021 | |
| Jeremy P Davis |
Corporate Officer |
Nov 26, 2018 | |
| Corporate Officer |
Nov 26, 2018 | ||
| W-2 Managing Employee |
Nov 26, 2018 | ||
| Teri S Champlin |
Corporate Director | Jan 1, 2014 | |
| Jared Cole Rogers |
Corporate Director | Dec 24, 2019 | |
| Robert Coulter |
Corporate Director | Jan 1, 2021 | |
| Michael E Billman |
Corporate Director | Jan 1, 2019 | |
| Grande Ronde Hospital Inc |
Operational/Managerial Control | May 31, 1966 | |
| Stacy Whitaker |
Corporate Director | Jan 1, 2018 | |
| Bradley D Trisler |
Corporate Director | Jan 1, 2010 | |
| Carla M Hagen |
Corporate Director | Feb 22, 2017 | |
| Floyd S Lyon |
Corporate Director | Jan 1, 2009 | |
| Libby H Goben |
Corporate Director | Jan 1, 2008 |
All facility ownership & control disclosures 6
| Facility | Type | Role | Since |
|---|---|---|---|
| Grande Ronde Hospital Inc |
Hospital | Operational/Managerial Control | May 31, 1966 |
| Grande Ronde Hospital Regional Medical Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Nov 1, 2005 |
| Grande Ronde Hospital Women'S & Children'S Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Nov 1, 1996 |
| Grande Ronde Hospital Union Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Nov 1, 2005 |
| Grande Ronde Hospital Elgin Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Nov 1, 2005 |
| Grande Ronde Hospital Urgent Care |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Sep 14, 2020 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
Locations
170 Ford Rd
John Day, OR 97845
Phone (541) 575-1311
700 Sunset Dr
Ste A
La Grande, OR 97850
Phone (541) 963-1919
710 Sunset Dr
Ste F
La Grande, OR 97850
Phone (541) 663-3100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 | Yes |
| 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
710 Sunset Dr Ste E
LA Grande, OR 97850-1200
Phone (541) 663-3150
Other practice location 2
700 Sunset Dr Ste C
LA Grande, OR 97850-1260
Phone (541) 663-3135
Other practice location 3
700 Sunset Dr Ste F
LA Grande, OR 97850-1260
Phone (541) 663-3030
Other practice location 4
700 Sunset Dr Ste A
LA Grande, OR 97850-1260
Phone (541) 963-1919
Other practice location 5
710 Sunset Dr Ste F
LA Grande, OR 97850-1200
Phone (541) 663-3100
Other practice location 6
10303 S Walton Rd
LA Grande, OR 97850-9413
Phone (541) 962-7845
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 067801 | Medicaid | OR |
Other providers in La Grande, OR
- Grande Ronde Hospital, Inc
- Grande Ronde Hospital, Inc.
- Grande Ronde Hospital, Inc.
- Grande Ronde Hospital, Inc.
- Grande Ronde Hospital, Inc.
- Grande Ronde Recovery
- Grande Ronde Therapeutic Massage
- Carly Gray
- Dianne Gray
- Kevin David Grayson
All providers in La Grande, OR · Critical Access Hospital in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.