NPIMap

Organization Active NPI

Virginia Garcia Memorial Health Center

  • Federally Qualified Health Center (FQHC)
  • Cornelius, OR
National Provider Identifier
1679528012
Registry record updated Aug 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 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
Last updated
Aug 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2023

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

Authorized official

Name
Annmarie Dennis
Title
Corporate Compliance Officer
Phone
(503) 214-1652

Specialties & licenses 1

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

Addresses

Primary practice location

1151 N Adair St
Cornelius, OR 97113-8900

Mailing address

PO Box 6149
Aloha, OR 97007-0149

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR5 enrollments

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
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

NPI to CCN mapping 4

The Medicare certification numbers (CCNs) connected to NPI 1679528012. Details of each certification follow.

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
CorporationNon-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
CorporationNon-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
CorporationNon-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
CorporationNon-profit
Incorporated
Jul 31, 1978 in OR
Enrollment address
115 NE May LN
McMinnville, OR 97128-9272

Other NPIs with the same Medicare PAC ID 9

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

Other NPIs on the same Medicare enrollment 12

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

National Provider Directory

National Provider Directory

Locations

13000 SW 2nd St
Beaverton, OR 97005
Phone (503) 259-5045

1998 SE Century Blvd
Hillsboro, OR 97129
Phone (503) 597-4580

232 SE 7th Ave
Hillsboro, OR 97123
Phone (503) 640-1614

2251 E Hancock St
Ste 103
Newberg, OR 97132
Phone (971) 281-3000

9000 SW Durham Rd
Bldg 7110
Tigard, OR 97224
Phone (503) 431-5775

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Wilfredo Figueroa Individual Corporate DirectorBoard Member Feb 1, 2009
Susan Felstiner Individual Corporate DirectorBoard Treasurer Oct 23, 2013
Corporate DirectorBoard Secretary Oct 23, 2013
Jessica Ann Kitt Individual Corporate DirectorSecretary Aug 23, 2017
Corporate DirectorBoard Secretary Aug 23, 2017
Corporate Director Aug 23, 2017
Annmarie Dennis Individual W-2 Managing Employee Apr 16, 2018
Operational/Managerial ControlCorporate Compliance Officer Apr 16, 2018
Gilles Martin Munoz Individual Corporate OfficerCeo Aug 5, 2005
Corporate Officer Jun 20, 2007
Corporate OfficerCeo May 5, 2005
Corporate OfficerCeo Jun 20, 2007
Ann E Barr Gillespie Individual Corporate DirectorBoard Member Jul 1, 2011
Rafal Decker Individual Corporate DirectorBoard Member Jun 24, 2015
Alejandra Aguilar Individual Corporate DirectorBoard Member Aug 1, 2010
Araceli Gaytan Individual Corporate OfficerCfo Jul 18, 2002
W-2 Managing EmployeeCfo Jul 18, 2007
Corporate Officer Jul 18, 2007
W-2 Managing EmployeeCfo Jun 20, 2007
Corporate OfficerChief Financial Officer Mar 12, 1987
Ernestina E Aranda Individual Corporate DirectorBoard Member Jun 1, 2006
Ricardo Palazuelos Individual Corporate DirectorBoard Vice Chair Oct 23, 2013
Corporate DirectorBoard Chair Oct 23, 2013
Laurinda Mackenzie Individual Corporate DirectorBoard Chair Sep 1, 2011
Joaquin Borrego Individual Corporate Director Sep 23, 2020
Michael Yates Individual Corporate Director Jul 24, 2019
Laurel Durham Individual Corporate Director Feb 28, 2018
Mary Ludlum Individual Corporate Director Mar 25, 2020
Ketan Sampt Individual Corporate Director Jul 24, 2019
Maria Loredo Individual W-2 Managing EmployeeCoo Jun 20, 2007

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Virginia Garcia Memorial Health CenterNewberg, OR, CCN 381947 Federally qualified health center Operational/Managerial Control Feb 28, 2014
Virginia Garcia Memorial Health CenterHillsboro, OR, CCN 381956 Federally qualified health center Operational/Managerial Control Feb 28, 2014
Virginia Garcia Memorial Health CenterHillsboro, OR, CCN 381010 Federally qualified health center Operational/Managerial Control May 2, 2022

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 195

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 195

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692403200000",
    "number": "1679528012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6149",
            "city": "ALOHA",
            "state": "OR",
            "postal_code": "970070149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 N ADAIR ST",
            "city": "CORNELIUS",
            "state": "OR",
            "postal_code": "971138900",
            "telephone_number": "503-359-5564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRGINIA GARCIA MEMORIAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2023-08-19",
        "certification_date": "2023-08-19",
        "status": "A",
        "authorized_official_last_name": "DENNIS",
        "authorized_official_first_name": "ANNMARIE",
        "authorized_official_title_or_position": "CORPORATE COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "503-214-1652"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cornelius, OR

Sources for this page

Verify at the official NPI Registry.