NPIMap

Organization Active NPI

Cascade Direct Care Inc

  • Medical Physician Assistant
  • Prineville, OR
National Provider Identifier
1902248776
Registry record updated Jul 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA151672 Issued in OR
Legal business name
CASCADE DIRECT CARE INC
Practice address
750 NW 4TH St
Prineville, OR 97754-1436
Phone
(541) 362-8688
Fax
(541) 550-7779
NPI assigned
Jul 22, 2013
Last updated
Jul 22, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2013

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

Authorized official

Name
Mrs. Lindsey G McKay, PA-C
Title
Owner
Phone
(541) 362-8688

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AM0700X PA151672 OR Primary

Addresses

Primary practice location

750 NW 4TH St
Prineville, OR 97754-1436

Mailing address

PO Box 648
Prineville, OR 97754-0648
Phone (541) 362-8688

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902248776. Details of each certification follow.

Rural health clinic certification: CCN 383886

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
CASCADE DIRECT CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 24, 2014
Last certification
Feb 24, 2014
Ownership / control type
1B
Facility address
750 NW 4TH Street
Prineville, OR 97754

National Provider Directory

National Provider Directory

Locations

198 NE Combs Flat Rd
Ste 110
Prineville, OR 97754
Phone (541) 362-8688

750 NW 4th St
Prineville, OR 97754
Phone (541) 362-8688

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1374451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374451200000",
    "number": "1902248776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 648",
            "city": "PRINEVILLE",
            "state": "OR",
            "postal_code": "977540648",
            "telephone_number": "541-362-8688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 NW 4TH ST",
            "city": "PRINEVILLE",
            "state": "OR",
            "postal_code": "977541436",
            "telephone_number": "541-362-8688",
            "fax_number": "541-550-7779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASCADE DIRECT CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-22",
        "last_updated": "2013-07-22",
        "status": "A",
        "authorized_official_last_name": "MCKAY",
        "authorized_official_first_name": "LINDSEY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-362-8688",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA151672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prineville, OR

Sources for this page

Verify at the official NPI Registry.