NPIMap

Organization Active NPI

Touchmark Living Centers, Inc

Doing business as Waterford at Three Fountains

  • Skilled Nursing Facility
  • Medford, OR
National Provider Identifier
1548205354
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
385126 Issued in OR
Legal business name
TOUCHMARK LIVING CENTERS, INC
Doing business as
Waterford at Three Fountains
Practice address
835 Crater Lake Ave
Medford, OR 97504-6505
Phone
(541) 773-7717
Fax
(541) 857-5139
NPI assigned
Jun 17, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Brian E Pryor
Title
VP Operations
Phone
(503) 646-5186

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 385126 OR Primary

Addresses

Primary practice location

835 Crater Lake Ave
Medford, OR 97504-6505

Mailing address

5150 SW Griffith Dr
Beaverton, OR 97005-2935
Phone (503) 646-5186

Other identifiers 1

IdentifierTypeStateIssuer
800545MedicaidOR

Other names 1

  • Waterford at Three Fountains Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Touchmark Living Centers4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548205354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 SW GRIFFITH DR",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970052935",
            "telephone_number": "503-646-5186",
            "fax_number": "503-646-5186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 CRATER LAKE AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046505",
            "telephone_number": "541-773-7717",
            "fax_number": "541-857-5139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOUCHMARK LIVING CENTERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PRYOR",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VP OPERATIONS",
        "authorized_official_telephone_number": "503-646-5186",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OR",
            "license": "385126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "800545",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waterford at Three Fountains",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.