NPIMap

Organization Active NPI

Santiam Memorial Hospital

  • Ambulance
  • Stayton, OR
National Provider Identifier
1962566752
Registry record updated Apr 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
2403 Issued in OR
Legal business name
SANTIAM MEMORIAL HOSPITAL
Practice address
1401 N 10TH Ave
Stayton, OR 97383-1311
Phone
(503) 769-9215
Fax
(503) 769-5312
NPI assigned
Dec 19, 2006
Last updated
Apr 2, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2008

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

Authorized official

Name
Mrs. Susan Brainard
Title
Director of Medical Records
Phone
(503) 769-9215

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 2403 OR Primary

Addresses

Primary practice location

1401 N 10TH Ave
Stayton, OR 97383-1311

Mailing address

1401 N 10TH Ave
Stayton, OR 97383-1311
Phone (503) 769-9215

Other identifiers 1

IdentifierTypeStateIssuer
000120MedicaidOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050422001024 OR Part A Provider - Hospital 6103729751 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Stayton, OR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962566752. Details of each certification follow.

Hospital certification: CCN 380056

Legal name
SANTIAM MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Feb 1, 2018
Beds
40
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Oct 15, 1950 in OR
Enrollment address
1401 N 10TH Ave
Stayton, OR 97383-1311
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Santiam Hospital & ClinicsCCN 380056 · All quality measures
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Paul Faringer MDD17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Melissa Baurer Individual Corporate OfficerExec Director Community Development Apr 1, 2025
Silvia Hernandez Individual Corporate DirectorBoard Member Feb 8, 2023 11.1%
Cassondra Posvar Martinez Individual Corporate OfficerExec Director Revenue&Reimbursement Apr 1, 2025
W-2 Managing EmployeeExec Director Revenue&Reimbursement Jan 1, 2021
Ed Diehl Individual Corporate DirectorBoard Member Apr 12, 2017 11.1%
Rachael Seeder Individual Corporate OfficerDirector of Finance Dec 1, 2020
Margaret a Hudson Individual Corporate OfficerCeo Jan 25, 1993
W-2 Managing EmployeeCeo Jan 25, 1993
Mike L Odenthal Individual Corporate DirectorBoard Member Mar 11, 1979
Pamela Ray Individual Corporate DirectorBoard Member Jun 12, 2019 11.1%
Steven M Vets Individual Corporate OfficerCmo Jan 15, 2021
Tiffanie Pye Individual Corporate OfficerCoo Oct 2, 2023
W-2 Managing EmployeeCoo Oct 2, 2023
James W Bayuk Individual Corporate DirectorBoard Member Feb 11, 2026 11.1%
Debbie Turrell Individual Corporate OfficerCno Apr 1, 2025
Genny Baldwin Individual Corporate DirectorBoard Member Jan 1, 2021 11.1%
Victor D Kintz Individual Corporate DirectorBoard Member May 12, 2003
Maryann F Meredith Individual Corporate DirectorBoard Member Jun 9, 1998
Emily Newton Individual Corporate DirectorBoard Member Feb 11, 2026 11.1%

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Affiliated clinicians 183

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 183

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207094400000",
    "number": "1962566752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 N 10TH AVE",
            "city": "STAYTON",
            "state": "OR",
            "postal_code": "973831311",
            "telephone_number": "503-769-9215",
            "fax_number": "503-769-5312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 N 10TH AVE",
            "city": "STAYTON",
            "state": "OR",
            "postal_code": "973831311",
            "telephone_number": "503-769-9215",
            "fax_number": "503-769-5312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTIAM MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2008-04-02",
        "status": "A",
        "authorized_official_last_name": "BRAINARD",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "DIRECTOR OF MEDICAL RECORDS",
        "authorized_official_telephone_number": "503-769-9215",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "OR",
            "license": "2403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000120",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stayton, OR

Sources for this page

Verify at the official NPI Registry.