NPIMap

Organization Active NPI

Albany General Hospital

Doing business as Samaritan Heartspring Wellness Center

  • Family Medicine Physician
  • Albany, OR
National Provider Identifier
1912263179
Registry record updated Sep 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ALBANY GENERAL HOSPITAL
Doing business as
Samaritan Heartspring Wellness Center
Practice address
534 Pleasant View Way NW, Suite 100
Albany, OR 97321-1700
Phone
(541) 812-5656
NPI assigned
Apr 2, 2012
Last updated
Sep 23, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2016

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

Authorized official

Name
David Triebes
Title
Ceo
Phone
(541) 812-5656

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

534 Pleasant View Way NW, Suite 100
Albany, OR 97321-1700

Mailing address

534 Pleasant View Way NW, Suite 100
Albany, OR 97321-1700
Phone (541) 812-5656

Other names 1

  • Samaritan Heartspring Wellness Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040310000310 OR Part B Supplier - Clinic/Group Practice 9931097987 Receives reassigned benefits from 473 practitioners
31 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Albany, OR

Other NPIs on the same Medicare enrollment 31

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 31

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
38D1029735Samaritan Heartspring Wellness Center534 Pleasant View Way NW Ste 100, Albany, OR 97321Certificate of waiverAug 14, 2027

National Provider Directory

National Provider Directory
Tax ID family
James L Erickson31 organizations share this tax ID, including this one

Other organizations with this tax ID 30

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

View all 30

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1333324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474588800000",
    "number": "1912263179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "534 PLEASANT VIEW WAY NW, SUITE 100",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211700",
            "telephone_number": "541-812-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "534 PLEASANT VIEW WAY NW, SUITE 100",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211700",
            "telephone_number": "541-812-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBANY GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-02",
        "last_updated": "2016-09-23",
        "status": "A",
        "authorized_official_last_name": "TRIEBES",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-812-5656"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Samaritan Heartspring Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albany, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.