Virginia Garcia Memorial Health Center
Organization Active NPI Federally Qualified Health Center (FQHC) · Cornelius, OR
NPI 1679528012 · NPPES record last updated Aug 19, 2023
Key facts
- NPI
- 1679528012
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- VIRGINIA GARCIA MEMORIAL HEALTH CENTER
- Practice address
- 1151 N Adair St
Cornelius, OR 97113-8900 - Phone
- (503) 359-5564
- NPI assigned
- May 24, 2006
- Organization subpart
- No
Authorized official
- Name
- Annmarie Dennis
- Title
- Corporate Compliance Officer
- Phone
- (503) 214-1652
Owned or controlled facilities with NPI records 3
Other NPIs on the same Medicare enrollment 12
Other NPIs with the same Medicare PAC ID 9
Practitioners 198
-
Lisa Kipersztok, MD, MPH
-
Karmen Vilander, AGNP
-
Austin Alexander, PA-C
-
Adrienne Batla, PA-C
-
Michael Burton, PA
-
Kelly N Crawford, DO
-
Rachael Crooke, PA
-
Sharon Frost Duggan, MSN, FNP
-
Rebecca Faulkner, APRN
-
Eva Marie Galvez, MD
-
Samantha George, MD, DIPABLM
-
Carolyn Lee Goebel, M.D.
-
John Palma Guerreiro, M.D.
-
Christian N Hill, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (5 enrollments) in OR
Federally qualified health center certification: CCN 381800
- Legal name
- VIRGINIA GARCIA MEMORIAL HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Oct 1, 1991
- Last certification
- Oct 1, 1991
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jul 31, 1978 in OR
- Enrollment address
- 1151 N Adair St
Cornelius, OR 97113-8900
Federally qualified health center certification: CCN 381900
- Legal name
- VIRGINIA GARCIA MEMORIAL HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Oct 4, 2007
- Last certification
- Oct 4, 2007
- Ownership / control type
- For profit – partnership
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jul 31, 1978 in OR
- Enrollment address
- 226 SE 8TH Avenue
Hillsboro, OR 97123-4218
Federally qualified health center certification: CCN 381898
- Legal name
- VIRGINIA GARCIA MEMORIAL HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Oct 4, 2007
- Last certification
- Oct 4, 2007
- Ownership / control type
- For profit – partnership
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jul 31, 1978 in OR
- Enrollment address
- 2725 SW Cedar Hills Blvd
Ste 200
Beaverton, OR 97005-1435
Federally qualified health center certification: CCN 381901
- Legal name
- VIRGINIA GARCIA MEMORIAL HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Oct 4, 2007
- Last certification
- Oct 4, 2007
- Ownership / control type
- For profit – partnership
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jul 31, 1978 in OR
- Enrollment address
- 115 NE May LN
McMinnville, OR 97128-9272
All disclosed owners & managing parties 18
| Name | Role | Since | Share |
|---|---|---|---|
| Wilfredo Figueroa |
Corporate Director |
Feb 1, 2009 | |
| Susan Felstiner |
Corporate Director |
Oct 23, 2013 | |
| Corporate Director |
Oct 23, 2013 | ||
| Jessica Ann Kitt |
Corporate Director |
Aug 23, 2017 | |
| Corporate Director |
Aug 23, 2017 | ||
| Corporate Director | Aug 23, 2017 | ||
| Annmarie Dennis |
W-2 Managing Employee | Apr 16, 2018 | |
| Operational/Managerial Control |
Apr 16, 2018 | ||
| Gilles Martin Munoz |
Corporate Officer |
Aug 5, 2005 | |
| Corporate Officer | Jun 20, 2007 | ||
| Corporate Officer |
May 5, 2005 | ||
| Corporate Officer |
Jun 20, 2007 | ||
| Ann E Barr Gillespie |
Corporate Director |
Jul 1, 2011 | |
| Rafal Decker |
Corporate Director |
Jun 24, 2015 | |
| Alejandra Aguilar |
Corporate Director |
Aug 1, 2010 | |
| Araceli Gaytan |
Corporate Officer |
Jul 18, 2002 | |
| W-2 Managing Employee |
Jul 18, 2007 | ||
| Corporate Officer | Jul 18, 2007 | ||
| W-2 Managing Employee |
Jun 20, 2007 | ||
| Corporate Officer |
Mar 12, 1987 | ||
| Ernestina E Aranda |
Corporate Director |
Jun 1, 2006 | |
| Ricardo Palazuelos |
Corporate Director |
Oct 23, 2013 | |
| Corporate Director |
Oct 23, 2013 | ||
| Laurinda Mackenzie |
Corporate Director |
Sep 1, 2011 | |
| Joaquin Borrego |
Corporate Director | Sep 23, 2020 | |
| Michael Yates |
Corporate Director | Jul 24, 2019 | |
| Laurel Durham |
Corporate Director | Feb 28, 2018 | |
| Mary Ludlum |
Corporate Director | Mar 25, 2020 | |
| Ketan Sampt |
Corporate Director | Jul 24, 2019 | |
| Maria Loredo |
W-2 Managing Employee |
Jun 20, 2007 |
All facility ownership & control disclosures 3
| Facility | Type | Role | Since |
|---|---|---|---|
| Virginia Garcia Memorial Health Center |
Federally qualified health center | Operational/Managerial Control | Feb 28, 2014 |
| Virginia Garcia Memorial Health Center |
Federally qualified health center | Operational/Managerial Control | Feb 28, 2014 |
| Virginia Garcia Memorial Health Center |
Federally qualified health center | Operational/Managerial Control | May 2, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031211000992 | OR | Part B Supplier - Clinic/Group Practice | 7113823881 |
Receives reassigned benefits from 168 practitioners 12 other NPIs on this enrollment Practice locations: Willamina, OR; Beaverton, OR; Sheridan, OR; Newberg, OR; McMinnville, OR; Hillsboro, OR; Cornelius, OR |
| O20050701000596 | OR | Part a Provider - Federally Qualified Health Center (FQHC) | 7113823881 | Practice locations: Cornelius, OR |
| O20070703000745 | OR | Part a Provider - Federally Qualified Health Center (FQHC) | 7113823881 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Hillsboro, OR |
| O20070703000748 | OR | Part a Provider - Federally Qualified Health Center (FQHC) | 7113823881 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Beaverton, OR |
| O20070703000752 | OR | Part a Provider - Federally Qualified Health Center (FQHC) | 7113823881 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: McMinnville, OR |
National Provider Directory
Locations
1998 SE Century Blvd
Hillsboro, OR 97129
Phone (503) 597-4580
2251 E Hancock St
Ste 103
Newberg, OR 97132
Phone (971) 281-3000
2251 E Hancock St
Newberg, OR 97132
Phone (971) 281-3000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
1151 N Adair St
Cornelius, OR 97113-8900
Mailing address
PO Box 6149
Aloha, OR 97007-0149
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 023197 | Medicaid | OR |
Other providers in Cornelius, OR
- Ruby Myrella Urbina
- Kathryn Leigh Urhausen
- Tiffany Van Dyke
- Roberto Varona Sr.
- Nohemi Vigil
- Virginia Garcia Memorial Health Center
- Virginia Garcia Memorial Health Center
- Virginia Garcia Memorial Health Center
- Wal-Mart Stores Inc
- Walgreen Co
All providers in Cornelius, 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 19, 2023. 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.