Santiam Memorial Hospital
Organization Active NPI Ambulance · Stayton, OR
NPI 1962566752 · NPPES record last updated Apr 2, 2008
Key facts
- NPI
- 1962566752
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulance 341600000X
- License
- 2403 (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
- Organization subpart
- No
Authorized official
- Name
- Mrs. Susan Brainard
- Title
- Director of Medical Records
- Phone
- (503) 769-9215
Owners & managing parties with NPI records 2
-
James W Bayuk, MD
-
Steven M Vets, DO
Other NPIs on the same Medicare enrollment 1
Corporate family (same tax ID) 16
Related certifications (CCN) 7
Affiliated clinicians 183
-
Pedro Abdala, MD
-
Deborah Kempe Ames, M.D.
-
Andreea Luiza Andone, M.D.
-
Maziar Azadpour, M.D.
-
Fayez A. Bader, M.D.
-
Tasha Barkley, M. D. M.P.H.
-
Michael Bass, PA-C
-
Martin L Bassett, MD, PC
-
Tashina Louise Blair, FNP-BC
-
Chandler McKay Boyd, PA-C
-
Theodore Paul Braun, M.D., PH.D.
-
Daniel C Butler, PA
-
Tauni Carter, P.A.-C.
-
Ian Cavigli, PA-C
-
McKenna Chandler, PA-S
-
Jasmin Chaudhary, MD
-
Michael C Chen, M.D.
-
Maurice Collada Jr., M.D.
Medicare Care Compare: Hospital
- Listed as
- Santiam Hospital & Clinics
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
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
- Corporation · Non-profit
- Incorporated
- Oct 15, 1950 in OR
- Enrollment address
- 1401 N 10TH Ave
Stayton, OR 97383-1311 - Hospital subgroups
- General, Acute care
All disclosed owners & managing parties 16
| Name | Role | Since | Share |
|---|---|---|---|
| Melissa Baurer |
Corporate Officer |
Apr 1, 2025 | |
| Silvia Hernandez |
Corporate Director |
Feb 8, 2023 | 11.1% |
| Cassondra Posvar Martinez |
Corporate Officer |
Apr 1, 2025 | |
| W-2 Managing Employee |
Jan 1, 2021 | ||
| Ed Diehl |
Corporate Director |
Apr 12, 2017 | 11.1% |
| Rachael Seeder |
Corporate Officer |
Dec 1, 2020 | |
| Margaret a Hudson |
Corporate Officer |
Jan 25, 1993 | |
| W-2 Managing Employee |
Jan 25, 1993 | ||
| Mike L Odenthal |
Corporate Director |
Mar 11, 1979 | |
| Pamela Ray |
Corporate Director |
Jun 12, 2019 | 11.1% |
| Steven M Vets |
Corporate Officer |
Jan 15, 2021 | |
| Tiffanie Pye |
Corporate Officer |
Oct 2, 2023 | |
| W-2 Managing Employee |
Oct 2, 2023 | ||
| James W Bayuk |
Corporate Director |
Feb 11, 2026 | 11.1% |
| Debbie Turrell |
Corporate Officer |
Apr 1, 2025 | |
| Genny Baldwin |
Corporate Director |
Jan 1, 2021 | 11.1% |
| Victor D Kintz |
Corporate Director |
May 12, 2003 | |
| Maryann F Meredith |
Corporate Director |
Jun 9, 1998 | |
| Emily Newton |
Corporate Director |
Feb 11, 2026 | 11.1% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- Santaim Memorial Hospit
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | 2403 | OR | Yes |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000120 | Medicaid | OR |
Other providers in Stayton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.