St. Charles Health System, Inc.
Organization Active NPI Clinical Social Worker · Bend, OR
NPI 1780698696 · NPPES record last updated May 5, 2023
Key facts
- NPI
- 1780698696
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Legal business name
- ST. CHARLES HEALTH SYSTEM, INC.
- Practice address
- 2542 NE Courtney Dr
Bend, OR 97701-7685 - Phone
- (541) 706-2768
- Fax
- (541) 706-4760
- NPI assigned
- Jul 28, 2006
- Organization subpart
- No
Authorized official
- Name
- Matthew Swafford
- Title
- Chief Financial Officer
- Phone
- (541) 382-4321
Other NPIs on the same Medicare enrollment 6
Corporate family (same tax ID) 18
Practitioners 161
-
Robert A Abernathy, M.D.
-
Laura Jane Adams, L.AC.
-
Carey L Allen, MD
-
Amy V Asher, DO
-
Steven Astengo, DO
-
Mackenzie Bartz, PA-C
-
Roberta G Belich, PA-C
-
Frank Bittner, DO
-
Mark A Bradford, M.D.
-
Shannon K Brasher, PA-C
-
Meghan G Brecke, DO
-
Bryce Campbell, PA-C
-
Michelle Cohen, M.D.
-
Shane M Coleman, M.D., MPH
-
Breanna Davis, CNM, WHNP
-
Jennifer Dixon, M.D.
-
Daniel B Doan, M.D.
-
Donna R Hamlin, LPC
-
Makary Thomas Hofmann, D.O.
-
Willow Huffine, PH.D.
-
Elke Jacobsen, PA
-
Fahad Jamil, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040112000045 | OR | Part B Supplier - Clinic/Group Practice | 3870402852 |
Receives reassigned benefits from 349 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Bend, OR; Sisters, OR; Redmond, OR; Prineville, OR; Madras, OR; La Pine, OR |
National Provider Directory
- Tax ID family
- Cascade Healthcare Community Inc
Locations
1885 NE Purcell Blvd
Bend, OR 97701
Phone (541) 322-2700
2036 NE Williamson Ct
Bend, OR 97701
Phone (541) 318-4249
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor |
101YP2500X | OR | ||
| Clinical Neuropsychologist |
103G00000X | OR | ||
| Clinical Psychologist |
103TC0700X | OR | ||
| Clinical Social Worker |
1041C0700X | OR | Yes |
Addresses
Primary practice location
2542 NE Courtney Dr
Bend, OR 97701-7685
Mailing address
PO Box 6095
Bend, OR 97708-6095
Phone (541) 382-4321
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500400455 | Medicaid | OR |
Other names
- St. Charles Behavioral Health
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Ability Network |
Other providers in Bend, OR
- St. Charles Health System, Inc.
- St. Charles Health System, Inc.
- St. Charles Health System, Inc.
- St. Charles Health System, Inc.
- St. Charles Health System, Inc.
- St. Charles Health System, Inc.
- St. Charles Health System, Inc.
- St. Charles Health System, Inc.
- St. Charles Health System, Inc.
- St. Charles Health Systems
All providers in Bend, OR · Clinical Social Worker in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 5, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.