Snake River Pediatrics

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

PA000573 Issued in OR

Legal business name

SNAKE RIVER PEDIATRICS

Practice address

1050 SW 3Rd Ave Ste 3200
Ontario, OR 97914-4560

Phone

(541) 881-2380

Fax

(541) 881-2389

NPI assigned

Jul 8, 2015

Organization subpart

No

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

Authorized official

Name

Stephen K Ames, MD

Title

President

Phone

(541) 881-2380

Specialties & licenses 2

Addresses

Other identifiers 2

Tax ID family

Snake River Pediatrics PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Snake River Pediatrics, PC

  • Rural Health Clinic/Center
  • Fruitland, ID
  • NPI 1700269792
  NPD tax ID
• Snake River Pediatrics, PC

  • Pediatrics Physician
  • Fruitland, ID
  • NPI 1871952267
  NPD tax ID

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

{
    "created_epoch": "1436313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436313600000",
    "number": "1891178885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 SW 3RD AVE STE 3200",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979144560",
            "telephone_number": "541-881-2380",
            "fax_number": "541-881-2389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 SW 3RD AVE STE 3200",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979144560",
            "telephone_number": "541-881-2380",
            "fax_number": "541-881-2389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNAKE RIVER PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-08",
        "last_updated": "2015-07-08",
        "status": "A",
        "authorized_official_last_name": "AMES",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-881-2380",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "PA000573",
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "OR",
            "license": "PA000573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1982791810",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500608077",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sally Melissa Sluder, AGACNP-BC
• Linda Smallwood
• Laurie J Smith, MHA
• Morris H Smith, MD
• Peter W. Smith, MS
• Snake River Radiology PC
• Brandon Alden Snow, DMD
• Maricela Sotelo
• Southern Idaho Regional Laboratory LLC (Treasure Valley Laboratory)
• Lacie Catherine Spagnola, OD

• Rural Health Clinic/Center in Ontario, OR
• Providers in Ontario, OR by specialty
• Rural Health Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2015; 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.