NPIMap

Organization Active NPI

Mid-Columbia Medical Center

  • Rehabilitation Hospital Unit
  • The Dalles, OR
National Provider Identifier
1851369409
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
14 0500 Issued in OR
Legal business name
MID-COLUMBIA MEDICAL CENTER
Practice address
1700 E 19TH St
The Dalles, OR 97058-3317
Phone
(541) 296-7760
Fax
(541) 296-7619
NPI assigned
Mar 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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

Authorized official

Name
Dennis Knox
Title
Corporate Officer Ceo
Phone
(541) 296-7273

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X 14 0500 OR Primary

Addresses

Primary practice location

1700 E 19TH St
The Dalles, OR 97058-3317

Mailing address

1700 E 19TH St
The Dalles, OR 97058-3317
Phone (541) 296-7760

Other identifiers 2

IdentifierTypeStateIssuer
2005186MedicaidWA
026484MedicaidOR

Other names 1

  • Adventist Health Columbia Gorge Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687132800000",
    "number": "1851369409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 E 19TH ST",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583317",
            "telephone_number": "541-296-7760",
            "fax_number": "541-296-7619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E 19TH ST",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583317",
            "telephone_number": "541-296-7760",
            "fax_number": "541-296-7619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-COLUMBIA MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-09",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A",
        "authorized_official_last_name": "KNOX",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "CORPORATE OFFICER CEO",
        "authorized_official_telephone_number": "541-296-7273"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "OR",
            "license": "14 0500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2005186",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026484",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adventist Health Columbia Gorge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.