NPIMap

Organization Active NPI

Winding Waters Medical Clinic

Doing business as Winding Waters Public Health

  • Federally Qualified Health Center (FQHC)
  • Enterprise, OR
National Provider Identifier
1881440899
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
WINDING WATERS MEDICAL CLINIC
Doing business as
Winding Waters Public Health
Practice address
107 SW 1St St
Enterprise, OR 97828-1285
Phone
(541) 426-4502
Fax
(541) 426-6403
NPI assigned
Apr 29, 2024
Last updated
Apr 29, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
WINDING WATERS MEDICAL CLINICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Authorized official

Name
Keli Jean Dennis
Title
Coo
Phone
(541) 426-4502

Specialties & licenses 1

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

Addresses

Primary practice location

107 SW 1St St
Enterprise, OR 97828-1285

Mailing address

603 Medical Pkwy
Enterprise, OR 97828-5124
Phone (541) 426-4502

Other names 1

  • Winding Waters Public Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Winding Waters Medical Clin6 organizations share this tax ID, including this one
Part of
Winding Waters Medical Clin

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1714348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714348800000",
    "number": "1881440899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 MEDICAL PKWY",
            "city": "ENTERPRISE",
            "state": "OR",
            "postal_code": "978285124",
            "telephone_number": "541-426-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 SW 1ST ST",
            "city": "ENTERPRISE",
            "state": "OR",
            "postal_code": "978281285",
            "telephone_number": "541-426-4502",
            "fax_number": "541-426-6403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINDING WATERS MEDICAL CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WINDING WATERS MEDICAL CLINIC",
        "enumeration_date": "2024-04-29",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A",
        "authorized_official_last_name": "DENNIS",
        "authorized_official_first_name": "KELI",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "541-426-4502"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Winding Waters Public Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Enterprise, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; 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.