NPIMap

Organization Active NPI

Asher Community Health Center

Doing business as Asher Clinic

  • Federally Qualified Health Center (FQHC)
  • Fossil, OR
National Provider Identifier
1811937485
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ASHER COMMUNITY HEALTH CENTER
Doing business as
Asher Clinic
Practice address
712 Jay St.
Fossil, OR 97830-0307
Phone
(541) 763-2725
Fax
(541) 763-2850
NPI assigned
Jun 8, 2006
Last updated
Sep 26, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Authorized official

Name
Mr. James Ivan Carlson
Title
Administrator
Phone
(541) 763-2725

Specialties & licenses 1

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

Addresses

Primary practice location

712 Jay St.
Fossil, OR 97830-0307

Mailing address

PO Box 307
Fossil, OR 97830-0307
Phone (541) 763-2725

Other identifiers 1

IdentifierTypeStateIssuer
276319MedicaidOR

Other names 1

  • Asher Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20050930000192 OR Part A Provider - Federally Qualified Health Center (FQHC) 2163460726 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Spray, OR
O20070608000181 OR Part B Supplier - Clinic/Group Practice 2163460726 Receives reassigned benefits from 19 practitioners
3 other NPIs on this enrollment
Practice locations: Christmas Valley, OR; Fossil, OR; Mitchell, OR; Spray, OR
O20101123000124 OR Part A Provider - Federally Qualified Health Center (FQHC) 2163460726 Practice locations: Fossil, OR

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1811937485. Details of each certification follow.

Federally qualified health center certification: CCN 381889

Legal name
ASHER COMMUNITY HEALTH CENTER
Doing business as
ASHER COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 5, 2005
Last certification
Oct 5, 2005
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 17, 2003 in OR
Enrollment address
211 Pine St
Spray, OR 97874-2013

Federally qualified health center certification: CCN 381888

Legal name
ASHER COMMUNITY HEALTH CENTER
Doing business as
ASHER CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 5, 2005
Last certification
Oct 5, 2005
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 17, 2003 in OR
Enrollment address
712 Jay St
Fossil, OR 97830-8371

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Teresa Hunt Individual Corporate OfficerCeo/Cfo Feb 2, 2020
Corporate OfficerCfo Jul 13, 2020
W-2 Managing EmployeeCfo Jul 13, 2020
Mary Ann Wilkins Individual W-2 Managing EmployeeCoo Jan 1, 2026
Linda G. Donnelly Individual Corporate Director Feb 20, 2020
Bonnie G Lofton Individual Corporate DirectorBoard Member Jul 15, 2015
Patricia T Ryno Individual Corporate OfficerBoard Member, Board Chair Person Mar 18, 2020
Corporate DirectorBoard Member, Board Chair Person Mar 18, 2020
Richard H Shaffer Individual Corporate Director Feb 20, 2020
Jane L Reeves Individual Corporate DirectorBoard Member Feb 19, 2020
Albert Pacheco Individual Corporate OfficerCeo May 14, 2021
Norman B. Andersen Individual Corporate DirectorBoard Member Feb 20, 2013
Susan L Moore Individual Corporate OfficerCoo Jul 13, 2020

Subparts reporting this organization as parent 4

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

Practitioners & affiliated clinicians

Practitioners 21

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 21

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695686400000",
    "number": "1811937485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 307",
            "city": "FOSSIL",
            "state": "OR",
            "postal_code": "978300307",
            "telephone_number": "541-763-2725",
            "fax_number": "541-763-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 JAY ST.",
            "city": "FOSSIL",
            "state": "OR",
            "postal_code": "978300307",
            "telephone_number": "541-763-2725",
            "fax_number": "541-763-2850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASHER COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "IVAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "541-763-2725",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276319",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Asher Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Asher Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fossil, OR

Sources for this page

Verify at the official NPI Registry.