NPIMap

Organization Active NPI

RCH Hep C Program

  • Federally Qualified Health Center (FQHC)
  • Medford, OR
National Provider Identifier
1578090221
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
RCH HEP C PROGRAM
Practice address
900 E Main St
Medford, OR 97504-7136
Phone
(541) 842-7704
NPI assigned
May 12, 2017
Organization subpart
Yes
Parent organization
ROGUE COMMUNITY HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

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

Authorized official

Name
Calisa North
Title
Cfo
Phone
(541) 842-7642

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

900 E Main St
Medford, OR 97504-7136

Mailing address

19 Myrtle St
Medford, OR 97504-7337

Other identifiers 2

IdentifierTypeStateIssuer
500667341MedicaidOR
227698MedicaidOR

National Provider Directory

National Provider Directory
Tax ID family
Community Health Center16 organizations share this tax ID, including this one
Part of
Community Health Center

Other organizations with this tax ID 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1494547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602720000000",
    "number": "1578090221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 MYRTLE ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E MAIN ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047136",
            "telephone_number": "541-842-7704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RCH HEP C PROGRAM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ROGUE COMMUNITY HEALTH",
        "enumeration_date": "2017-05-12",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A",
        "authorized_official_last_name": "NORTH",
        "authorized_official_first_name": "CALISA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "541-842-7642"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500667341",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "227698",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Oct 15, 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.