Active NPI
State of Oregon Department of Veterans Affairs
- Skilled Nursing Facility
- The Dalles, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 800072
- Legal business name
- STATE OF OREGON DEPARTMENT OF VETERANS AFFAIRS
- Practice address
- 700 Veterans Dr
The Dalles, OR 97058-9757 - Phone
- (541) 296-7190
- Fax
- (541) 296-2339
- NPI assigned
- Oct 25, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Edward Van Dyke
- Title
- Deputy Director
- Phone
- (503) 373-2387
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 800072 | OR | Primary |
Addresses
Primary practice location
700 Veterans Dr
The Dalles, OR 97058-9757
Mailing address
700 Summer St NE
Salem, OR 97301-1285
Phone (503) 373-2000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 800072 | Medicaid | OR | |
| 73426380 | Other | OR | OVH REGISTRY NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040524000937 | OR | Part A Provider - Skilled Nursing Facility | 4789675000 | Practice locations: The Dalles, OR |
Skilled nursing facility certification: CCN 385257
- Legal name
- STATE OF OREGON DEPARTMENT OF VETERANS AFFAIRS
- Doing business as
- OREGON VETERANS HOME
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Apr 29, 1998
- Last certification
- Mar 14, 2025
- Beds
- 151
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Government
- Enrollment address
- 700 Veterans Dr
The Dalles, OR 97058-9757 - Nursing home name
- OREGON VETERANS HOME
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- Skilled Nursing Facility
- Lebanon, OR
- NPI 1679985113
4789675000
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Oregon Veterans Home
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Apr 29, 1998
- Medicare certification status
- Active
- Certified beds
- 151
- Abuse citation
- Cited for abuse (Care Compare abuse icon)
- Penalties (3 years)
- 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 38D0935151 | Oregon Veterans Home | Certificate of waiver | Dec 31, 2027 |
National Provider Directory
National Provider DirectoryMember organizations 1
Organizations listed as members of this organization in the National Provider Directory.
-
- Skilled Nursing Facility
- Lebanon, OR
- NPI 1679985113
Member Of
Locations
700 Summer St NE
Salem, OR 97301
Ownership & related parties
All disclosed owners & managing parties 6
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Veterans Care Centers of Oregon | Operational/Managerial Control | Oct 1, 2003 | 100% |
| State of Oregon Department of Veterans Affairs | 5% Or Greater Direct Ownership Interest | Oct 1, 2003 | 100% |
| Westcare Management Inc | Operational/Managerial Control | Oct 1, 2003 | 100% |
| Donna K Haole Valenzuela | Corporate Officer | Mar 1, 2022 | 100% |
| Bryan Decker | Operational/Managerial Control | Oct 1, 2003 | 100% |
| Tara Pray | W-2 Managing Employee | Jun 14, 2022 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Skilled Nursing Facility
- Lebanon, OR
- NPI 1679985113
5% Or Greater Direct Ownership Interest
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Lebanon Veterans Home | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Oct 1, 2014 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Skilled Nursing Facility
- Lebanon, OR
- NPI 1679985113
5% Or Greater Direct Ownership Interest
Facilities with the same owner 1
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Lebanon, OR
- NPI 1679985113
State of Oregon Department of Veterans Affairs, Veterans Care Centers of Oregon, Westcare Management Inc
Practitioners & affiliated clinicians
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1426636800000",
"number": "1831274364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 SUMMER ST NE",
"city": "SALEM",
"state": "OR",
"postal_code": "973011285",
"telephone_number": "503-373-2000",
"fax_number": "503-373-2362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 VETERANS DR",
"city": "THE DALLES",
"state": "OR",
"postal_code": "970589757",
"telephone_number": "541-296-7190",
"fax_number": "541-296-2339"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "STATE OF OREGON DEPARTMENT OF VETERANS AFFAIRS",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-25",
"last_updated": "2015-03-18",
"status": "A",
"authorized_official_last_name": "VAN DYKE",
"authorized_official_first_name": "EDWARD",
"authorized_official_title_or_position": "DEPUTY DIRECTOR",
"authorized_official_telephone_number": "503-373-2387"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "OR",
"license": "800072",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "800072",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OVH REGISTRY NUMBER",
"identifier": "73426380",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in The Dalles, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.