NPIMap

Organization Active NPI

Mid-Valley Healthcare Inc

Doing business as Samaritan OMT Lebanon

  • Pain Medicine Physician
  • Lebanon, OR
National Provider Identifier
1912940396
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
MID-VALLEY HEALTHCARE INC
Doing business as
Samaritan OMT Lebanon
Practice address
100 Mullins Dr Ste C
Lebanon, OR 97355-3982
Phone
(541) 451-7460
Fax
(541) 451-7454
NPI assigned
Jun 14, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Joseph M Cahill III
Title
Ceo
Phone
(541) 557-6441

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X Primary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X

Addresses

Primary practice location

100 Mullins Dr Ste C
Lebanon, OR 97355-3982

Mailing address

100 Mullins Drive, Suite C
Lebanon, OR 97355-2868
Phone (541) 451-7460

Other names 1

  • Samaritan OMT Lebanon Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000297 OR Part B Supplier - Clinic/Group Practice 2769391523 Receives reassigned benefits from 458 practitioners
27 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lebanon, OR; Sweet Home, OR; Newport, OR; Halsey, OR; Brownsville, OR

Other NPIs on the same Medicare enrollment 27

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

View all 27

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1912940396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MULLINS DRIVE, SUITE C",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973552868",
            "telephone_number": "541-451-7460",
            "fax_number": "541-451-7454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MULLINS DR STE C",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973553982",
            "telephone_number": "541-451-7460",
            "fax_number": "541-451-7454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-VALLEY HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CAHILL",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-557-6441",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Samaritan OMT Lebanon",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Samaritan OMT Lebanon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lebanon, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.

Verify at the official NPI Registry.