NPIMap

Organization Active NPI

Santiam Memorial Hospital

Doing business as Cascade Medical Clinic

  • Rural Health Clinic/Center
  • Stayton, OR
National Provider Identifier
1790171874
Registry record updated Sep 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SANTIAM MEMORIAL HOSPITAL
Doing business as
Cascade Medical Clinic
Practice address
1369 N 10TH Ave
Stayton, OR 97383-2037
Phone
(503) 769-7546
Fax
(503) 769-8563
NPI assigned
Apr 15, 2015
Last updated
Sep 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2022

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

Authorized official

Name
Maggie Hudson
Title
Coo/Cfo
Phone
(503) 769-9236

Specialties & licenses 1

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

Addresses

Primary practice location

1369 N 10TH Ave
Stayton, OR 97383-2037

Mailing address

1369 N 10TH Ave
Stayton, OR 97383-2037
Phone (503) 769-7546

Other names 1

  • Cascade Medical Clinic Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040130000239 OR Part B Supplier - Clinic/Group Practice 6103729751 Receives reassigned benefits from 154 practitioners
22 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mill City, OR; Aumsville, OR; Sublimity, OR; Stayton, OR
O20150209002033 OR Part A Provider - Rural Health Clinic 6103729751 Practice locations: Sublimity, OR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790171874. Details of each certification follow.

Rural health clinic certification: CCN 388523

Legal name
SANTIAM MEMORIAL HOSPITAL
Doing business as
SUBLIMITY MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 1, 2016
Last certification
Jun 1, 2023
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Dec 31, 1951 in OR
Enrollment address
114 SE Church St
Sublimity, OR 97385-9714
Related CCNs
380056

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

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 22

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

View all 22

National Provider Directory

National Provider Directory
Tax ID family
Santaim Memorial Hospit17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Melissa Baurer Individual Corporate OfficerExec Director Revenue&Reimbursement Apr 1, 2025
Silvia Hernandez Individual Corporate DirectorBoard Member Feb 8, 2023 11.1%
Cassondra Posvar Martinez Individual Corporate OfficerExec Director Revenue&Reimbursement Apr 1, 2025
W-2 Managing EmployeeExec Director Revenue&Reimbursement Jan 1, 2021
Ed Diehl Individual Corporate DirectorBoard Member Apr 12, 2017 11.1%
Rachael Seeder Individual Corporate OfficerDirector of Finance Dec 1, 2020
Margaret a Hudson Individual Corporate OfficerCeo Jan 25, 1993
W-2 Managing EmployeeCeo Jan 25, 1993
Mike L Odenthal Individual Corporate DirectorBoard Member Jan 1, 1999 11.1%
Pamela Ray Individual Corporate DirectorBoard Member Jun 12, 2019 11.1%
Steven M Vets Individual Corporate OfficerCmo Jan 15, 2021
Tiffanie Pye Individual Corporate OfficerCoo Oct 2, 2023
W-2 Managing EmployeeCoo Oct 2, 2023
James W Bayuk Individual Corporate DirectorBoard Member Feb 11, 2026 11.1%
Debbie Turrell Individual Corporate OfficerCno Apr 1, 2025
Genny Baldwin Individual Corporate DirectorBoard Member Jan 1, 2021 11.1%
Victor D Kintz Individual Corporate DirectorBoard Member Jan 1, 2003 11.1%
Maryann F Meredith Individual Corporate DirectorBoard Member Jan 1, 1998 11.1%
Emily Newton Individual Corporate DirectorBoard Member Feb 11, 2026 11.1%

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1429056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663891200000",
    "number": "1790171874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1369 N 10TH AVE",
            "city": "STAYTON",
            "state": "OR",
            "postal_code": "973832037",
            "telephone_number": "503-769-7546",
            "fax_number": "503-769-8563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1369 N 10TH AVE",
            "city": "STAYTON",
            "state": "OR",
            "postal_code": "973832037",
            "telephone_number": "503-769-7546",
            "fax_number": "503-769-8563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTIAM MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-15",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "MAGGIE",
        "authorized_official_title_or_position": "COO/CFO",
        "authorized_official_telephone_number": "503-769-9236"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cascade Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cascade Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stayton, OR

Sources for this page

Verify at the official NPI Registry.