NPIMap

Organization Active NPI

Santiam Memorial Hospital

Doing business as Sublimity Medical Clinic

  • Rural Health Clinic/Center
  • Sublimity, OR
National Provider Identifier
1518354547
Registry record updated Apr 16, 2015
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
Sublimity Medical Clinic
Practice address
114 SE Church St
Sublimity, OR 97385-9714
Phone
(503) 769-2259
Fax
(503) 769-8049
NPI assigned
Apr 16, 2015
Last updated
Apr 16, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2015

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

Authorized official

Name
Maggie Hudson
Title
Coo/Cfo
Phone
(503) 769-9236

Specialties & licenses 1

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

Addresses

Primary practice location

114 SE Church St
Sublimity, OR 97385-9714

Mailing address

PO Box 886
Sublimity, OR 97385-0886
Phone (503) 769-2259

Other names 1

  • Sublimity Medical Clinic 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
O20150209001771 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 1518354547. Details of each certification follow.

Rural health clinic certification: CCN 388522

Legal name
SANTIAM MEMORIAL HOSPITAL
Doing business as
CASCADE MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 17, 2016
Last certification
Apr 30, 2024
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Dec 31, 1951 in OR
Enrollment address
1369 N 10TH Ave
Stayton, OR 97383-2037
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
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 Nov 1, 2020
Mike L Odenthal Individual Corporate DirectorBoard Member Jan 1, 1999 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 Jan 1, 2003 11.1%
Maryann F Meredith Individual Corporate DirectorBoard Member Jan 1, 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 21

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 21

NPI Registry JSON

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

{
    "created_epoch": "1429142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429142400000",
    "number": "1518354547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 886",
            "city": "SUBLIMITY",
            "state": "OR",
            "postal_code": "973850886",
            "telephone_number": "503-769-2259",
            "fax_number": "503-769-8049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 SE CHURCH ST",
            "city": "SUBLIMITY",
            "state": "OR",
            "postal_code": "973859714",
            "telephone_number": "503-769-2259",
            "fax_number": "503-769-8049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTIAM MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-16",
        "last_updated": "2015-04-16",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "MAGGIE",
        "authorized_official_title_or_position": "COO/CFO",
        "authorized_official_telephone_number": "503-769-9236"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sublimity Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sublimity, OR

Sources for this page

Verify at the official NPI Registry.