Pine Eagle Health Planning Committee
Organization
Active NPI
Land Ambulance · Halfway, OR
NPI 1497858773 · NPPES record last updated Jun 17, 2020
Key facts
- NPI
- 1497858773
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 0105 (OR)
- Legal business name
- PINE EAGLE HEALTH PLANNING COMMITTEE
- Practice address
- 223 Center Street
Halfway, OR 97834
- Phone
- (541) 742-7425
- Fax
- (541) 742-7425
- NPI assigned
- Sep 5, 2006
- Organization subpart
- No
Authorized official
- Name
- Terra Lewis
- Title
- Administrator
- Phone
- (541) 742-5024
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
Dean Nathanial Defrees, MD
Family Medicine Physician · Baker City, OR · NPI 1073924361
-
Kathryn L Grace, PA-C
Physician Assistant · Halfway, OR · NPI 1467575639
-
J Daniel Smithson, MD
Family Medicine Physician · Baker City, OR · NPI 1427046820
-
Korey Vance Ham, MN, FNP-C, APRN
Family Nurse Practitioner · Baker City, OR · NPI 1285153932
Laboratory certificates & supplier records
Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|
| 38D0902297 | Halfway-Oxbow Ambulance Service-Lab
223 Center Street, Halfway, OR 97834 | Certificate of waiver | Dec 31, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|
Pine Eagle Clinic
Halfway, OR · CCN 383869 |
Rural health clinic |
Operational/Managerial Control |
Dec 12, 1977 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|
| O20060501000342 |
OR |
Part B Supplier - Ambulance Service Supplier |
8729075346 |
Practice locations: Halfway, OR |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|
| Land Ambulance |
3416L0300X |
0105 |
OR |
Yes |
Addresses
Primary practice location
223 Center Street
Halfway, OR 97834
Mailing address
PO Box 488
223 Center Street
Halfway, OR 97834-0488
Phone (541) 742-7425
Other identifiers
| Identifier | Type | State | Issuer |
|---|
| 085944 | Medicaid | OR | |
Other names
- Halfway-Oxbow Ambulance Doing business as
- VFW Halfway Oxobw Ambulance Doing business as
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2020. 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.
Verify at the official NPI Registry.