NPIMap

Organization Active NPI

Samaritan North Lincoln Hospital

  • Urology Physician
  • Lincoln City, OR
National Provider Identifier
1679927636
Registry record updated Jan 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
SAMARITAN NORTH LINCOLN HOSPITAL
Practice address
3100 NE 28TH St Ste B
Lincoln City, OR 97367-4524
Phone
(541) 812-5820
NPI assigned
Apr 15, 2016
Last updated
Jan 25, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2018

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

Authorized official

Name
Lesley J. Ogden, MD
Title
Ceo
Phone
(541) 996-7100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

3100 NE 28TH St Ste B
Lincoln City, OR 97367-4524

Mailing address

3100 NE 28TH St Ste B
Lincoln City, OR 97367-4524
Phone (541) 812-5800

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040120000329 OR Part B Supplier - Clinic/Group Practice 7911816301 Receives reassigned benefits from 300 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lincoln City, OR
O20061104000117 OR Part A Provider - Critical Access Hospital 7911816301 Receives reassigned benefits from 289 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lincoln City, OR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679927636. Details of each certification follow.

Hospital certification: CCN 381302

Legal name
SAMARITAN NORTH LINCOLN HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Sep 1, 2000
Last certification
Jan 13, 2017
Beds
15
Ownership / control type
Private (not for profit)
Organization structure
OtherNon-profit
Incorporated
Jan 1, 2001 in OR
Enrollment address
3043 NE 28TH St
Lincoln City, OR 97367-4518
Other Hospital Practice Location

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

Other NPIs on the same Medicare enrollment 12

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Samaritan North Lincoln HospitalCCN 381302 · All quality measures
Overall star rating
3 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Samaritan North Lincoln Dialysis15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

3100 NE 28th St
#B
Lincoln City, OR 97367
Phone (541) 768-6930

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Samaritan Health Services Inc. Organization, Corvallis, OR Non-profit, Chain home office Operational/Managerial Control Jan 1, 2001 100%
Kelley Kaiser Individual Corporate DirectorBoard of Directors Dec 31, 2019
Darrell Dean Orton Individual Corporate DirectorBoard of Director Jan 1, 2004
Joseph Cahill Individual Corporate Director Dec 31, 2008 100%
W-2 Managing EmployeeCeo Dec 31, 2008 100%
Operational/Managerial ControlCeo Dec 31, 2008 100%
Terry Buggenhagen Individual Corporate DirectorBoard Member Aug 16, 2018
Lesley J Ogden Individual Corporate OfficerCeo Dec 15, 2015
Corporate DirectorCeo Dec 15, 2015
W-2 Managing EmployeeCeo Dec 15, 2015
Operational/Managerial ControlCeo Dec 15, 2015
Christine Chandler Individual Corporate DirectorBoard of Directors Jan 1, 2001
June Chrisman Individual Corporate DirectorBoard Member Aug 16, 2018
Elizabeth Ann Butler Individual Corporate DirectorSecretary Jan 1, 2017
Stuart Pritchard Individual Corporate DirectorBoard Member Aug 16, 2018
Doug Boysen Individual Corporate OfficerChair Jan 10, 2018
Richard Townsend Individual Corporate DirectorBoard of Directors Mar 17, 2004

Practitioners & affiliated clinicians

Practitioners 29

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 29

Affiliated clinicians 326

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 326

NPI Registry JSON

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

{
    "created_epoch": "1460678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516838400000",
    "number": "1679927636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 NE 28TH ST STE B",
            "city": "LINCOLN CITY",
            "state": "OR",
            "postal_code": "973674524",
            "telephone_number": "541-812-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 NE 28TH ST STE B",
            "city": "LINCOLN CITY",
            "state": "OR",
            "postal_code": "973674524",
            "telephone_number": "541-812-5820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITAN NORTH LINCOLN HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-15",
        "last_updated": "2018-01-25",
        "status": "A",
        "authorized_official_last_name": "OGDEN",
        "authorized_official_first_name": "LESLEY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-996-7100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln City, OR

Sources for this page

Verify at the official NPI Registry.