Active NPI
County of Jefferson
- Public Health or Welfare Agency
- Madras, OR
National Provider Identifier
1891716783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health or Welfare Agency
- License
- CH-0000017
- Legal business name
- COUNTY OF JEFFERSON
- Practice address
- 500 NE a St Ste 102
Madras, OR 97741-1842 - Phone
- (541) 475-4456
- Fax
- (541) 475-0132
- NPI assigned
- Jul 23, 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
- Katherine Russell, MPH
- Title
- Director
- Phone
- (541) 475-4456
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | CH-0000017 | OR | Primary |
Addresses
Primary practice location
500 NE a St Ste 102
Madras, OR 97741-1842
Mailing address
500 NE a St Ste 102
Madras, OR 97741-1842
Phone (541) 475-4456
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 320424 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20260107002451 | OR | Part B Supplier - Clinic/Group Practice | 1355313677 |
Receives reassigned benefits from 1 practitioner 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Madras, OR |
Other NPIs on the same Medicare enrollment 3
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Tax ID family
- County of Jefferson
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Case Management Agency
- Madras, OR
- NPI 1063561959
-
- Public Health or Welfare Agency
- Madras, OR
- NPI 1114643459
Locations
715 SW 4th St
Ste C
Madras, OR 97741
Phone (541) 475-4456
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153612800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757289600000",
"number": "1891716783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 NE A ST STE 102",
"city": "MADRAS",
"state": "OR",
"postal_code": "977411842",
"telephone_number": "541-475-4456",
"fax_number": "541-475-0132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 NE A ST STE 102",
"city": "MADRAS",
"state": "OR",
"postal_code": "977411842",
"telephone_number": "541-475-4456",
"fax_number": "541-475-0132"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COUNTY OF JEFFERSON",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-23",
"last_updated": "2025-09-08",
"certification_date": "2025-09-08",
"status": "A",
"authorized_official_last_name": "RUSSELL",
"authorized_official_first_name": "KATHERINE",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "541-475-4456",
"authorized_official_credential": "MPH"
},
"taxonomies": [
{
"code": "251K00000X",
"taxonomy_group": "",
"desc": "Public Health or Welfare",
"state": "OR",
"license": "CH-0000017",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "320424",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Madras, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; 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.