NPIMap

Organization Active NPI

Mid-Columbia Medical Center

Doing business as Adventist Health Columbia Gorge

  • Multi-Specialty Clinic/Center
  • Hood River, OR
National Provider Identifier
1568979680
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
MID-COLUMBIA MEDICAL CENTER
Doing business as
Adventist Health Columbia Gorge
MCMC Specialty Clinics at Nichols Landing
Practice address
33 Nichols Pkwy
Hood River, OR 97031-3121
Phone
(541) 308-1010
Fax
(541) 308-1011
NPI assigned
Jan 10, 2018
Last updated
Jun 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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

Authorized official

Name
Dennis Knox
Title
Corporate Officer Ceo
Phone
(541) 296-7273

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

33 Nichols Pkwy
Hood River, OR 97031-3121

Mailing address

PO Box 1520
The Dalles, OR 97058-8003

Other names 2

  • Adventist Health Columbia Gorge Doing business as
  • MCMC Specialty Clinics at Nichols Landing Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031209000244 OR Part B Supplier - Clinic/Group Practice 3779487251 Receives reassigned benefits from 219 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hood River, OR; The Dalles, OR

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D2009938MCMC Specialty Clinics at Nichols Landing33 Nichols Parkway, Hood River, OR 97031Certificate of waiverFeb 24, 2027

National Provider Directory

National Provider Directory
Tax ID family
The Dalles Family Pract6 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

33 Nichols Pkwy
Hood River, OR 97031
Phone (541) 308-1010

551 Lone Pine Blvd
The Dalles, OR 97058
Phone (541) 296-7202

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1515542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687132800000",
    "number": "1568979680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1520",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970588003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 NICHOLS PKWY",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970313121",
            "telephone_number": "541-308-1010",
            "fax_number": "541-308-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-COLUMBIA MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-10",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A",
        "authorized_official_last_name": "KNOX",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "CORPORATE OFFICER CEO",
        "authorized_official_telephone_number": "541-296-7273"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adventist Health Columbia Gorge",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MCMC Specialty Clinics at Nichols Landing",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MCMC Specialty Clinics at Nichols Landing",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hood River, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.