NPIMap

Organization Active NPI

La Clinica del Valle Family Health Care Center Inc.

Doing business as Women's Health Center La Clinica

  • Federally Qualified Health Center (FQHC)
  • Medford, OR
National Provider Identifier
1679896278
Registry record updated May 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC.
Doing business as
Women's Health Center La Clinica
Practice address
221 W Stewart Ave
Medford, OR 97501-3609
Phone
(541) 690-3500
NPI assigned
Mar 10, 2010
Last updated
May 24, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2019

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

Authorized official

Name
Mrs. Brenda Irene Johnson, RN, MBA
Title
Ceo
Phone
(541) 512-3151

Specialties & licenses 1

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

Addresses

Primary practice location

221 W Stewart Ave
Medford, OR 97501-3609

Mailing address

931 Chevy Way
Medford, OR 97504-4127
Phone (541) 535-6239

Other names 1

  • Women's Health Center La Clinica Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031107000627 OR Part B Supplier - Clinic/Group Practice 0244143089 Receives reassigned benefits from 87 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Medford, OR; Ashland, OR; Central Point, OR

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Locations

221 W Stewart Ave
Medford, OR 97501
Phone (541) 690-3500

Interoperability endpoints

  • Direct secure messaging: kim.mcquoid.laclinicahealthcenter@jhie.net
  • Direct secure messaging: linda.brouzes.laclinicahealthcenter@jhie.net
  • Direct secure messaging: linda.harris.laclinicahealthcenter@jhie.net
  • Direct secure messaging: mary.cutler.laclinicahealthcenter@jhie.net

Ownership & related parties

Subparts reporting this organization as parent 28

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

View all 28

Practitioners & affiliated clinicians

Practitioners 40

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 40

NPI Registry JSON

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

{
    "created_epoch": "1268179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558656000000",
    "number": "1679896278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 CHEVY WAY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044127",
            "telephone_number": "541-535-6239",
            "fax_number": "541-842-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W STEWART AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975013609",
            "telephone_number": "541-690-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-10",
        "last_updated": "2019-05-24",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "IRENE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-512-3151",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN, MBA"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Women's Health Center La Clinica",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Women's Health Center La Clinica",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.