Active NPI
Rainbow Valley Pediatrics
- Rural Health Clinic/Center
- Silverton, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rural Health Clinic/Center
- Legal business name
- RAINBOW VALLEY PEDIATRICS
- Practice address
- 605 Welch Street
Silverton, OR 97381 - Phone
- (503) 782-1975
- Fax
- (503) 343-6232
- NPI assigned
- May 31, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Alan Evert Edwards, MD
- Title
- Administrator
- Phone
- (724) 312-1931
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | |||
| Rural Health Clinic/Center | 261QR1300X | Primary |
Addresses
Primary practice location
605 Welch Street
Silverton, OR 97381
Mailing address
3780 Victor Point Rd NE
Silverton, OR 97381-9580
Phone (503) 400-0454
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20251113003060 | OR | Part A Provider - Rural Health Clinic | 5597256909 | Practice locations: Silverton, OR |
Rural health clinic certification: CCN 383924
- Legal name
- RAINBOW VALLEY PEDIATRICS
- Doing business as
- RAINBOW VALLEY PEDIATRICS
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Feb 25, 2026
- Last certification
- Feb 25, 2026
- Ownership / control type
- 1B
- Organization structure
- LLC
- Enrollment address
- 605 Welch St
Silverton, OR 97381-1946
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 38D2287424 | Rainbow Valley Pediatrics | Certificate of waiver | Aug 13, 2027 |
National Provider Directory
National Provider DirectoryOwnership & 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.
| Name | Role | Since | Share |
|---|---|---|---|
| Monique Vaquera | W-2 Managing Employee | Aug 14, 2023 | |
| Alan E Edwards | W-2 Managing Employee | Jun 2, 2025 | |
| Douglas S Hamblin | 5% Or Greater Direct Ownership Interest | Apr 10, 2023 | 100% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Emergency Medicine Physician
- Renovo, PA
- NPI 1124003157
-
- Physician Assistant
- Salem, OR
- NPI 1417142266
-
- Pediatrics Physician
- Silverton, OR
- NPI 1326299843
-
- Family Nurse Practitioner
- Salem, OR
- NPI 1942965140
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685491200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1775088000000",
"number": "1558054916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3780 VICTOR POINT RD NE",
"city": "SILVERTON",
"state": "OR",
"postal_code": "973819580",
"telephone_number": "503-400-0454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "605 WELCH STREET",
"city": "SILVERTON",
"state": "OR",
"postal_code": "97381",
"telephone_number": "503-782-1975",
"fax_number": "503-343-6232"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RAINBOW VALLEY PEDIATRICS",
"organizational_subpart": "NO",
"enumeration_date": "2023-05-31",
"last_updated": "2026-04-02",
"certification_date": "2026-04-02",
"status": "A",
"authorized_official_last_name": "EDWARDS",
"authorized_official_first_name": "ALAN",
"authorized_official_middle_name": "EVERT",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "724-312-1931",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pediatrics",
"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": []
}
Other providers in Silverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.