NPIMap

Organization Active NPI

DHS/Office of Financial Services Irs/Eopc/BMRC/Eotc/Osh/Osh-P

Doing business as Oregon State Hospital (Salem)

  • Psychiatric Hospital
  • Salem, OR
National Provider Identifier
1508802489
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
140160 Issued in OR
Legal business name
DHS/OFFICE OF FINANCIAL SERVICES IRS/EOPC/BMRC/EOTC/OSH/OSH-P
Doing business as
Oregon State Hospital (Salem)
Practice address
2600 Center St NE
Salem, OR 97301-2669
Phone
(503) 945-2800
Fax
(503) 945-2807
NPI assigned
Jun 21, 2006
Last updated
Dec 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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

Authorized official

Name
Karen Jamieson
Title
Chief Financial Officer
Phone
(503) 947-2676

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X 140160 OR Primary

Addresses

Primary practice location

2600 Center St NE
Salem, OR 97301-2669

Mailing address

PO Box 14900
Salem, OR 97309-5016
Phone (503) 945-9840

Other practice location 1

29398 Recovery Way
Junction City, OR 97448-8447
Phone (541) 465-2554

Other identifiers 1

IdentifierTypeStateIssuer
500670567MedicaidOR

Other names 1

  • Oregon State Hospital (Salem) Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031022000021 OR Part A Provider - Hospital 0547170383 Practice locations: Junction City, OR; Salem, OR
O20040130000453 OR Part B Supplier - Clinic/Group Practice 0547170383 Receives reassigned benefits from 130 practitioners
2 other NPIs on this enrollment
Practice locations: Salem, OR; Junction City, OR

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1508802489. Details of each certification follow.

Hospital certification: CCN 384008

Legal name
DHS OFFICE OF FINANCIAL SERVICES IRS EOPC BMRC EOTC OSH OSH-P
Doing business as
OREGON STATE HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
May 30, 1986
Last certification
Sep 27, 2024
Beds
604 (96 certified)
Ownership / control type
State
Organization structure
GovernmentNon-profit
Incorporated
May 30, 1986 in OR
Enrollment address
2600 Center St NE
Salem, OR 97301-2669
Main/Primary Hospital Location
Hospital subgroups
Other

Hospital certification: CCN 38002E

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
OREGON STATE HOSPITAL- SALEM
Certification status
Active
Provider type (POS)
Hospital
Participating since
Jul 31, 1997
Last certification
Jul 31, 1997
Beds
529 (151 certified)
Facility address
2600 Center Street NE
Salem, OR 97301

Care Compare: Hospital

Medicare Care Compare
Listed as
Oregon State Hospital Distinct PartCCN 384008 · All quality measures
Type
Psychiatric
Ownership
Government - State
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Oregon State Hospital6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1121 NE 2nd Ave
Portland, OR 97232
Phone (503) 731-8620

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
DHS Office of Financial Services Irs Eopc BMRC Eotc Osh Osh-P Organization, Salem, OR Non-profit 5% Or Greater Direct Ownership Interest May 30, 1986 100%
Operational/Managerial Control May 30, 1986 100%
Laura Fouts Individual W-2 Managing EmployeeBusiness Services Director Jun 17, 2019
Karen Jamieson Individual W-2 Managing EmployeeChief Financial Officer Feb 11, 2019

Practitioners & affiliated clinicians

Practitioners 131

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 131

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669939200000",
    "number": "1508802489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14900",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973095016",
            "telephone_number": "503-945-9840",
            "fax_number": "503-947-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 CENTER ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012669",
            "telephone_number": "503-945-2800",
            "fax_number": "503-945-2807"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29398 Recovery Way",
            "address_purpose": "LOCATION",
            "city": "Junction City",
            "state": "OR",
            "postal_code": "974488447",
            "country_code": "US",
            "telephone_number": "541-465-2554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DHS/OFFICE OF FINANCIAL SERVICES IRS/EOPC/BMRC/EOTC/OSH/OSH-P",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A",
        "authorized_official_last_name": "JAMIESON",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "503-947-2676"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "OR",
            "license": "140160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500670567",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oregon State Hospital (Salem)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Oregon State Hospital (Salem)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.