NPIMap

Organization Active NPI

Albany General Hospital

Doing business as Mid-Valley Childrens Clinic

  • Pediatrics Physician
  • Albany, OR
National Provider Identifier
1932465192
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
ALBANY GENERAL HOSPITAL
Doing business as
Mid-Valley Childrens Clinic
Practice address
734 Elm St SW
Albany, OR 97321-1934
Phone
(541) 812-5111
NPI assigned
Apr 2, 2012
Last updated
Apr 2, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

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) 812-4102

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Primary

Addresses

Primary practice location

734 Elm St SW
Albany, OR 97321-1934

Mailing address

734 Elm St SW
Albany, OR 97321-1934
Phone (541) 812-5111

Other names 1

  • Mid-Valley Childrens Clinic 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

National Provider Directory

National Provider Directory
Tax ID family
Carl Matthey31 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

Locations

734 Elm St SW
Albany, OR 97321
Phone (541) 812-5111

Practitioners & affiliated clinicians

Practitioners 33

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 33

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": "1333324800000",
    "number": "1932465192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "734 ELM ST SW",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211934",
            "telephone_number": "541-812-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "734 ELM ST SW",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211934",
            "telephone_number": "541-812-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBANY GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-02",
        "last_updated": "2012-04-02",
        "status": "A",
        "authorized_official_last_name": "TRIEBES",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-812-4102"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mid-Valley Childrens Clinic",
            "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 Apr 2, 2012; 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.