NPIMap

Organization Active NPI

Silverton Health

Doing business as Legacy Woodburn Health Center

  • Rural Health Clinic/Center
  • Woodburn, OR
National Provider Identifier
1679686463
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SILVERTON HEALTH
Doing business as
Legacy Woodburn Health Center
Practice address
1475 Mt. Hood Ave
Woodburn, OR 97071
Phone
(503) 982-2174
Fax
(503) 982-4599
NPI assigned
Aug 16, 2006
Last updated
May 11, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
SILVERTON HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 11, 2017

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

Authorized official

Name
Linda Hoff
Title
Cfo
Phone
(503) 415-5730

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

1475 Mt. Hood Ave
Woodburn, OR 97071

Mailing address

PO Box 3417
Portland, OR 97208-3417
Phone (503) 873-1500

Other identifiers 2

IdentifierTypeStateIssuer
213081MedicaidOR
R0000WFBRZOtherORMEDICARE- PART B

Other names 1

  • Legacy Woodburn Health Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040129000172 OR Part B Supplier - Clinic/Group Practice 8921901877 Receives reassigned benefits from 620 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Silverton, OR; Woodburn, OR; Salem, OR; Mount Angel, OR; Molalla, OR; Keizer, OR
O20050616000345 OR Part A Provider - Rural Health Clinic 8921901877 Practice locations: Woodburn, OR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679686463. Details of each certification follow.

Rural health clinic certification: CCN 388500

Legal name
SILVERTON HEALTH
Doing business as
LEGACY MEDICAL GROUP - WOODBURN HEALTH CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 4, 2005
Last certification
Mar 11, 2025
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jul 25, 1918 in OR
Enrollment address
1475 Mount Hood Ave
Ste 120
Woodburn, OR 97071-9066
Related CCNs
380029

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 14

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

View all 14

National Provider Directory

National Provider Directory
Part of
Molalla Family Practice

Locations

1650 NW Naito Pkwy
Ste 185
Portland, OR 97209
Phone (503) 525-7658

Ownership & related parties

All disclosed owners & managing parties 23

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

NameRoleSinceShare
Joseph H Frankhouse Individual Corporate DirectorBoard Member Jun 1, 2023
Jack Friedman Individual Corporate DirectorBoard Member Jun 1, 2018
Edgar Navas Individual Corporate DirectorBoard Member Jun 1, 2020
Richard P Reiten Individual Corporate DirectorBoard Member Jul 25, 2013
Jerry Petty Individual Corporate DirectorBoard Member Jun 1, 2018
Charles Wilhoite Individual Corporate DirectorChair Sep 15, 2015
Nancy Locke Individual Corporate DirectorBoard Member Jun 1, 2016
Leslie Root Individual Corporate DirectorBoard Member Jan 1, 2012
Jeffrey Barber Individual Corporate DirectorBoard Member Jul 25, 2012
Legacy Health Organization, Portland, OR Operational/Managerial Control Jun 1, 2016
Nancy Horton Individual Corporate DirectorBoard Member Jun 1, 2019
Craig Armstrong Individual Corporate DirectorSecretary Sep 1, 2023
Teresa L Handy Individual Corporate OfficerVP, Revenue Cycle Feb 27, 2012
W-2 Managing EmployeeVP, Revenue Cycle Operations Feb 27, 2012
Lynn T Gust Individual Corporate DirectorBoard Member Jun 1, 2017
George Joseph Brown Individual Corporate DirectorBoard President Jun 10, 2024
Gayle Goschie Individual Corporate DirectorBoard Member Jun 1, 2016
Lisa Freedman Individual Corporate DirectorBoard Member Jun 1, 2017
Nathalie Johnson Individual Corporate DirectorBoard Member Jun 1, 2023
Nasreen a Ilias-Khan Individual Corporate Director May 15, 2021
David Ramus Individual Corporate DirectorVice Chair May 15, 2014
Silverton Health Organization, Silverton, OR Non-profit 5% Or Greater Direct Ownership Interest Aug 4, 2005
Operational/Managerial Control Aug 4, 2005
Samir B Desai Individual Corporate DirectorBoard Member Jun 1, 2017
Carolyn Coggins Individual Corporate DirectorTreasurer Sep 22, 2025

Owners & managing parties with NPI records 8

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Legacy Medical Group - Mt. AngelMount Angel, OR, CCN 383999 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Aug 4, 2005

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 13

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 13

Practitioners & affiliated clinicians

Practitioners 117

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 117

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494460800000",
    "number": "1679686463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3417",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083417",
            "telephone_number": "503-873-1500",
            "fax_number": "503-873-1534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 MT. HOOD AVE",
            "city": "WOODBURN",
            "state": "OR",
            "postal_code": "97071",
            "telephone_number": "503-982-2174",
            "fax_number": "503-982-4599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SILVERTON HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SILVERTON HEALTH",
        "enumeration_date": "2006-08-16",
        "last_updated": "2017-05-11",
        "status": "A",
        "authorized_official_last_name": "HOFF",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "503-415-5730"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213081",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE- PART B",
            "identifier": "R0000WFBRZ",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Woodburn Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodburn, OR

Sources for this page

Verify at the official NPI Registry.