NPIMap

Organization Active NPI

Samaritan North Lincoln Hospital

Doing business as Samaritan Occupational Medicine-Lincoln City

  • Occupational Medicine Physician
  • Lincoln City, OR
National Provider Identifier
1942698154
Registry record updated Nov 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
Legal business name
SAMARITAN NORTH LINCOLN HOSPITAL
Doing business as
Samaritan Occupational Medicine-Lincoln City
Practice address
2930 NE West Devils Lake Rd Ste 3
Lincoln City, OR 97367-5195
Phone
(541) 557-6427
Fax
(541) 812-2071
NPI assigned
Dec 23, 2014
Last updated
Nov 8, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2018

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

Authorized official

Name
Lesley J. Ogden, MD
Title
Ceo
Phone
(541) 996-7100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Physician 2083X0100X OR Primary

Addresses

Primary practice location

2930 NE West Devils Lake Rd Ste 3
Lincoln City, OR 97367-5195

Mailing address

2930 NE West Devils Lake Rd Ste 3
Lincoln City, OR 97367-5195
Phone (541) 557-6427

Other identifiers 1

IdentifierTypeStateIssuer
500748439MedicaidOR

Other names 1

  • Samaritan Occupational Medicine-Lincoln City Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040120000329 OR Part B Supplier - Clinic/Group Practice 7911816301 Receives reassigned benefits from 300 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lincoln City, OR

Other NPIs on the same Medicare enrollment 12

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

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
38D2094375Samaritan Occupational Medicine-Lincoln City2930 NE West Devils Lake Rd, Ste 3, Lincoln City, OR 97367Certificate of waiverApr 14, 2027

National Provider Directory

National Provider Directory
Tax ID family
Samaritan North Lincoln15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Locations

3043 NE 28th St
Lincoln City, OR 97367
Phone (541) 994-3661

Practitioners & affiliated clinicians

Practitioners 32

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 32

NPI Registry JSON

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

{
    "created_epoch": "1419292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541635200000",
    "number": "1942698154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2930 NE WEST DEVILS LAKE RD STE 3",
            "city": "LINCOLN CITY",
            "state": "OR",
            "postal_code": "973675195",
            "telephone_number": "541-557-6427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 NE WEST DEVILS LAKE RD STE 3",
            "city": "LINCOLN CITY",
            "state": "OR",
            "postal_code": "973675195",
            "telephone_number": "541-557-6427",
            "fax_number": "541-812-2071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITAN NORTH LINCOLN HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-23",
        "last_updated": "2018-11-08",
        "status": "A",
        "authorized_official_last_name": "OGDEN",
        "authorized_official_first_name": "LESLEY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-996-7100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500748439",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Samaritan Occupational Medicine-Lincoln City",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Samaritan Occupational Medicine-Lincoln City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lincoln City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2018; 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.