Organization Active NPI

Eugene Lane Associates

Doing business as Emerald Valley Assisted Living

  • Assisted Living Facility
  • Eugene, OR
National Provider Identifier
1902067036
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
1723683654 Issued in OR
Legal business name
EUGENE LANE ASSOCIATES
Doing business as
Emerald Valley Assisted Living
Practice address
4550 W Amazon Dr
Eugene, OR 97405-5232
Phone
(541) 345-9668
Fax
(541) 345-1190
NPI assigned
Jun 20, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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

Authorized official

Name
Elizabeth Marie Moss
Title
Director of Risk Management
Phone
(503) 588-2725

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 1723683654 OR Primary

Addresses

Primary practice location

4550 W Amazon Dr
Eugene, OR 97405-5232

Mailing address

200 Hawthorne Ave SE Ste A140
Salem, OR 97301-5092
Phone (503) 588-2725

Other identifiers 1

IdentifierTypeStateIssuer
524285MedicaidOR

Other names 1

  • Emerald Valley Assisted Living Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D2096741Emerald Valley Assisted Living4550 West Amazon Drive, Eugene, OR 97405Certificate of waiverMay 31, 2027

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1902067036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWTHORNE AVE SE STE A140",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973015092",
            "telephone_number": "503-588-2725",
            "fax_number": "503-588-8653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 W AMAZON DR",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974055232",
            "telephone_number": "541-345-9668",
            "fax_number": "541-345-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EUGENE LANE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-20",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "MOSS",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DIRECTOR OF RISK MANAGEMENT",
        "authorized_official_telephone_number": "503-588-2725"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OR",
            "license": "1723683654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "524285",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emerald Valley Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.

Verify at the official NPI Registry.