NPIMap

Organization Active NPI

Santiam Memorial Hospital

Doing business as Santiam Medical Associates

  • Rural Health Clinic/Center
  • Stayton, OR
National Provider Identifier
1477909570
Registry record updated Oct 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SANTIAM MEMORIAL HOSPITAL
Doing business as
Santiam Medical Associates
Practice address
1401 N 10TH Ave
Ste. 100
Stayton, OR 97383-1486
Phone
(503) 769-6386
Fax
(503) 769-5647
NPI assigned
May 6, 2016
Last updated
Oct 22, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2018

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

Authorized official

Name
Lynda Fraser
Title
Clinic Director
Phone
(503) 769-9254

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

1401 N 10TH Ave
Ste. 100
Stayton, OR 97383-1486

Mailing address

1401 N 10TH Ave
Ste. 100
Stayton, OR 97383-1486
Phone (503) 769-6386

Other names 1

  • Santiam Medical Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR2 enrollments

Enrollment records 2

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
O20180328002926 OR Part A Provider - Rural Health Clinic 6103729751 Practice locations: Stayton, OR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477909570. Details of each certification follow.

Rural health clinic certification: CCN 388535

Legal name
SANTIAM MEMORIAL HOSPITAL
Doing business as
SANTIAM MEDICAL ASSOCIATES
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 29, 2018
Last certification
Aug 20, 2025
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Dec 31, 1951 in OR
Enrollment address
1401 N 10TH Ave
Ste 100
Stayton, OR 97383-1486
Related CCNs
380056

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 22

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

View all 22

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Melissa Baurer Individual Corporate OfficerExec Director Community Development Apr 1, 2025
Silvia Hernandez Individual Corporate DirectorBoard Member Feb 8, 2023 11.1%
Cassondra Posvar Martinez Individual Corporate OfficerExec Director Revenue&Reimbursement Apr 1, 2025
W-2 Managing EmployeeExec Director Revenue&Reimbursement Jan 1, 2021
Ed Diehl Individual Corporate DirectorBoard Member Apr 12, 2017 11.1%
Rachael Seeder Individual Corporate OfficerDirector of Finance Dec 1, 2020
Margaret a Hudson Individual Corporate OfficerCeo Jan 25, 1993
W-2 Managing EmployeeCeo Jan 25, 1993
Mike L Odenthal Individual Corporate DirectorBoard Member Mar 11, 1979 11.1%
Pamela Ray Individual Corporate DirectorBoard Member Jun 12, 2019 11.1%
Steven M Vets Individual Corporate OfficerCmo Jan 15, 2021
Tiffanie Pye Individual Corporate OfficerCoo Oct 2, 2023
W-2 Managing EmployeeCoo Oct 2, 2023
James W Bayuk Individual Corporate DirectorBoard Member Feb 11, 2026 11.1%
Debbie Turrell Individual Corporate OfficerCno Apr 1, 2025
Genny Baldwin Individual Corporate DirectorBoard Member Jan 1, 2021 11.1%
Victor D Kintz Individual Corporate DirectorBoard Member May 12, 2003 11.1%
Maryann F Meredith Individual Corporate DirectorBoard Member Jun 9, 1998 11.1%
Emily Newton Individual Corporate DirectorBoard Member Feb 11, 2026 11.1%

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1462492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540166400000",
    "number": "1477909570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 N 10TH AVE",
            "address_2": "STE. 100",
            "city": "STAYTON",
            "state": "OR",
            "postal_code": "973831486",
            "telephone_number": "503-769-6386",
            "fax_number": "503-769-5647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 N 10TH AVE",
            "address_2": "STE. 100",
            "city": "STAYTON",
            "state": "OR",
            "postal_code": "973831486",
            "telephone_number": "503-769-6386",
            "fax_number": "503-769-5647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTIAM MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-06",
        "last_updated": "2018-10-22",
        "status": "A",
        "authorized_official_last_name": "FRASER",
        "authorized_official_first_name": "LYNDA",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "503-769-9254"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Santiam Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Santiam Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stayton, OR

Sources for this page

Verify at the official NPI Registry.