NPIMap

Organization Active NPI

Mid-Valley Healthcare, Inc.

Doing business as Samaritan Specialty Clinic - Lebanon

  • Family Medicine Physician
  • Lebanon, OR
National Provider Identifier
1831247105
Registry record updated Nov 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MID-VALLEY HEALTHCARE, INC.
Doing business as
Samaritan Specialty Clinic - Lebanon
Practice address
675 N 5TH St
Lebanon, OR 97355
Phone
(541) 451-6282
NPI assigned
Jan 5, 2007
Last updated
Nov 13, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2018

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

Authorized official

Name
Joseph M. Cahill III
Title
Ceo
Phone
(541) 451-7914

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

675 N 5TH St
Lebanon, OR 97355

Mailing address

675 N 5TH St
Lebanon, OR 97355-2875
Phone (541) 451-6282

Other names 1

  • Samaritan Specialty Clinic - Lebanon Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000297 OR Part B Supplier - Clinic/Group Practice 2769391523 Receives reassigned benefits from 458 practitioners
27 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lebanon, OR; Sweet Home, OR; Newport, OR; Halsey, OR; Brownsville, OR

Other NPIs on the same Medicare enrollment 27

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

View all 27

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 20

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 20

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542067200000",
    "number": "1831247105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 N 5TH ST",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973552875",
            "telephone_number": "541-451-6282",
            "fax_number": "541-451-6282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 N 5TH ST",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "97355",
            "telephone_number": "541-451-6282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-VALLEY HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2018-11-13",
        "status": "A",
        "authorized_official_last_name": "CAHILL",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-451-7914",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Samaritan Specialty Clinic - Lebanon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lebanon, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; 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.