NPIMap

Organization Active NPI

Morrow County Health District

Doing business as Irrigon Medical Clinic

  • Rural Health Clinic/Center
  • Irrigon, OR
National Provider Identifier
1952331282
Registry record updated May 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
141444 Issued in OR
Legal business name
MORROW COUNTY HEALTH DISTRICT
Doing business as
Irrigon Medical Clinic
Practice address
220 N. Main St.
Irrigon, OR 97844
Phone
(541) 922-5880
Fax
(541) 922-5881
NPI assigned
Jul 3, 2006
Last updated
May 24, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2016

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

Authorized official

Name
Mrs. Nicole Mahoney
Title
Cfo
Phone
(541) 922-5880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 141444 OR Primary

Addresses

Primary practice location

220 N. Main St.
Irrigon, OR 97844

Mailing address

PO Box 9
Heppner, OR 97836-0009
Phone (541) 922-5880

Other identifiers 1

IdentifierTypeStateIssuer
168735MedicaidOR

Other names 1

  • Irrigon Medical Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050712000528 OR Part A Provider - Rural Health Clinic 2365359296 Practice locations: Irrigon, OR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1952331282. Details of each certification follow.

Rural health clinic certification: CCN 383987

Legal name
MORROW COUNTY HEALTH DISTRICT
Doing business as
IRRIGON MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 15, 1999
Last certification
Jul 19, 2024
Ownership / control type
2B
Organization structure
OtherNon-profit
Enrollment address
220 NE Main Ave
Irrigon, OR 97844-6999

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
38D0953445Irrigon Medical Clinic220 N Main Street, Irrigon, OR 97844Certificate of waiverDec 3, 2027

National Provider Directory

National Provider Directory
Tax ID family
Boardman Clinic8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Morrow County Health District Organization, Heppner, OR 5% Or Greater Direct Ownership Interest Sep 1, 1998 100%
Annetta Spicer Individual Corporate DirectorDirector Jul 1, 2025
Stephen Munkers Individual Corporate Director Jul 1, 2023
Janet Greenup Individual Corporate DirectorDirector Jul 1, 2025
Jason Hanna Individual Corporate DirectorDirector Jul 1, 2025
Julie Baker Individual Corporate OfficerChief Compliance Officer Jul 1, 2025
W-2 Managing EmployeeChief Compliance Officer Jul 1, 2025
Russel J Nichols Individual Corporate DirectorDirector Jul 1, 2025

Owners & managing parties with NPI records 7

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Pioneer Memorial Hospital & Nursing FacilityHeppner, OR, CCN 38Z310 Hospital 5% Or Greater Direct Ownership Interest Jan 13, 2010
Pioneer Memorial Home HealthHeppner, OR, CCN 387038 Home health agency 5% Or Greater Direct Ownership Interest Mar 4, 2010
Pioneer Memorial HospiceHeppner, OR, CCN 381546 Hospice 5% Or Greater Direct Ownership Interest (100%) Sep 9, 2002
Pioneer Memorial ClinicHeppner, OR, CCN 383984 Rural health clinic 5% Or Greater Direct Ownership Interest Mar 4, 2010
Morrow County Health DistrictIone, OR, CCN 388518 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Aug 17, 2015

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 3

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": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464048000000",
    "number": "1952331282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "HEPPNER",
            "state": "OR",
            "postal_code": "978360009",
            "telephone_number": "541-922-5880",
            "fax_number": "541-922-5881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 N. MAIN ST.",
            "city": "IRRIGON",
            "state": "OR",
            "postal_code": "97844",
            "telephone_number": "541-922-5880",
            "fax_number": "541-922-5881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORROW COUNTY HEALTH DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2016-05-24",
        "status": "A",
        "authorized_official_last_name": "MAHONEY",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "541-922-5880",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "OR",
            "license": "141444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168735",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Irrigon Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Irrigon, OR

Sources for this page

Verify at the official NPI Registry.