NPIMap

Organization Active NPI

La Pine Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Gilchrist, OR
National Provider Identifier
1669889341
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LA PINE COMMUNITY HEALTH CENTER
Practice address
350 Mississippi Dr
Gilchrist, OR 97737-3243
Phone
(541) 536-3435
Fax
(541) 536-3332
NPI assigned
Jul 15, 2014
Last updated
Aug 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

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

Authorized official

Name
Marie Manes
Title
Ceo
Phone
(541) 536-3435

Specialties & licenses 1

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

Addresses

Primary practice location

350 Mississippi Dr
Gilchrist, OR 97737-3243

Mailing address

51600 Huntington Rd # 101
La Pine, OR 97739-8887
Phone (541) 536-3435

Other identifiers 1

IdentifierTypeStateIssuer
38-1953OtherORCMS CERTIFICATION NUMBER

Other names 1

  • Gilchrist School Based Health Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090611000055 OR Part B Supplier - Clinic/Group Practice 8224187018 Receives reassigned benefits from 23 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gilchrist, OR; La Pine, OR; Lapine, OR
O20140812000273 OR Part A Provider - Federally Qualified Health Center (FQHC) 8224187018 Practice locations: Gilchrist, OR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669889341. Details of each certification follow.

Federally qualified health center certification: CCN 381953

Legal name
LA PINE COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 8, 2014
Last certification
Aug 8, 2014
Ownership / control type
Non-profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 5, 2008 in OR
Enrollment address
350 Mississippi Dr
Gilchrist, OR 97737-3243

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
La Pine Community Health Center5 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

51600 Huntington Rd
Ste C
La Pine, OR 97739
Phone (541) 536-3435

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Rio M Lion Individual Corporate OfficerCmo Sep 12, 2023
Tammy L Lesueur Individual Corporate DirectorBoard Member Oct 25, 2022
Erin Trapp Individual Corporate OfficerCeo Nov 1, 2022
Karen Forman Individual W-2 Managing EmployeeCfo Dec 5, 2022
Pamela J Perrine Individual Corporate DirectorBoard Member Apr 26, 2022
Marie L Manes Individual Corporate OfficerCoo Jan 1, 2016
W-2 Managing EmployeeCoo Jun 1, 2009
Ethel L Dumon Individual Corporate DirectorBoard Member May 23, 2023
Sheila Lusby Individual Corporate DirectorBoard Member Sep 23, 2025
Suzanne Marquez Individual Corporate DirectorBoard Member Aug 26, 2025
David F Gosser Individual Corporate DirectorBoard Member Aug 19, 2008
Kirk Cushing Individual Corporate DirectorBoard Member Jul 22, 2025
Linda M Bauman Individual Corporate DirectorBoard Member Mar 22, 2022
Ryan Maciej Individual Corporate DirectorBoard Member Nov 23, 2021
Ricky S Davis Individual Corporate DirectorBoard Member Jul 26, 2022
Christie a Rudder Individual Corporate DirectorBoard Member Jan 23, 2024

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 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786579200000",
    "number": "1669889341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51600 HUNTINGTON RD # 101",
            "city": "LA PINE",
            "state": "OR",
            "postal_code": "977398887",
            "telephone_number": "541-536-3435",
            "fax_number": "541-536-8047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 MISSISSIPPI DR",
            "city": "GILCHRIST",
            "state": "OR",
            "postal_code": "977373243",
            "telephone_number": "541-536-3435",
            "fax_number": "541-536-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA PINE COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-15",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A",
        "authorized_official_last_name": "MANES",
        "authorized_official_first_name": "MARIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-536-3435"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMS CERTIFICATION NUMBER",
            "identifier": "38-1953",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gilchrist School Based Health Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Gilchrist School Based Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gilchrist, OR

Sources for this page

Verify at the official NPI Registry.