La Pine Community Health Center
Organization Active NPI Federally Qualified Health Center (FQHC) · Gilchrist, OR
NPI 1669889341 · NPPES record last updated Aug 13, 2026
Key facts
- NPI
- 1669889341
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 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
- Organization subpart
- No
Authorized official
- Name
- Marie Manes
- Title
- Ceo
- Phone
- (541) 536-3435
Owners & managing parties with NPI records 1
-
Rio Lion, D.O
Other NPIs on the same Medicare enrollment 2
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 4
Practitioners 18
-
Sarah Grosse, APRN
-
Rio Lion, D.O
-
Patrick J. McCarthy, M.D.
-
Zoe Pearlman, PA-C
-
Rebecca M Brewer, PA-C
-
Janice Cody, FNP
-
Tyson Lee Langeliers, PA -C, ATC, LAT
-
Joe T McCook, MD
-
Adaobi Okonkwo, MD
-
Sarah Danielle Sperry, PA-C
-
Cari Nicole Welch, LPC
-
Brian Taylor Evans, PSYD
-
Amanda Fields, DO
-
Jillian Marcucci, M.A.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OR
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
- Corporation · Non-profit
- Incorporated
- Aug 5, 2008 in OR
- Enrollment address
- 350 Mississippi Dr
Gilchrist, OR 97737-3243
All disclosed owners & managing parties 15
| Name | Role | Since | Share |
|---|---|---|---|
| Rio M Lion |
Corporate Officer |
Sep 12, 2023 | |
| Tammy L Lesueur |
Corporate Director |
Oct 25, 2022 | |
| Erin Trapp |
Corporate Officer |
Nov 1, 2022 | |
| Karen Forman |
W-2 Managing Employee |
Dec 5, 2022 | |
| Pamela J Perrine |
Corporate Director |
Apr 26, 2022 | |
| Marie L Manes |
Corporate Officer |
Jan 1, 2016 | |
| W-2 Managing Employee |
Jun 1, 2009 | ||
| Ethel L Dumon |
Corporate Director |
May 23, 2023 | |
| Sheila Lusby |
Corporate Director |
Sep 23, 2025 | |
| Suzanne Marquez |
Corporate Director |
Aug 26, 2025 | |
| David F Gosser |
Corporate Director |
Aug 19, 2008 | |
| Kirk Cushing |
Corporate Director |
Jul 22, 2025 | |
| Linda M Bauman |
Corporate Director |
Mar 22, 2022 | |
| Ryan Maciej |
Corporate Director |
Nov 23, 2021 | |
| Ricky S Davis |
Corporate Director |
Jul 26, 2022 | |
| Christie a Rudder |
Corporate Director |
Jan 23, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- La Pine Community Health Center
Locations
51600 Huntington Rd
Ste 101
La Pine, OR 97739
Phone (541) 536-3435
51600 Huntington Rd
Ste C
La Pine, OR 97739
Phone (541) 536-3435
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38-1953 | Other | OR | CMS CERTIFICATION NUMBER |
Other names
- Gilchrist School Based Health Center
Other providers in Gilchrist, OR
All providers in Gilchrist, OR · Federally Qualified Health Center (FQHC) in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.