NPIMap

Organization Active NPI

Santiam Medical Group LLC

  • Clinic/Center
  • Stayton, OR
National Provider Identifier
1992149322
Registry record updated Apr 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SANTIAM MEDICAL GROUP LLC
Practice address
1401 N 10TH Ave
Stayton, OR 97383-1311
Phone
(503) 769-2175
Fax
(503) 769-5877
NPI assigned
Apr 29, 2013
Last updated
Apr 29, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2013

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

Authorized official

Name
Maggie Hudson
Title
Cfo/Coo
Phone
(503) 769-9236

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU 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) 769-2175

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1367193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367193600000",
    "number": "1992149322",
    "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": "503-769-2175",
            "fax_number": "503-769-5877"
        },
        {
            "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": "503-769-2175",
            "fax_number": "503-769-5877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTIAM MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-29",
        "last_updated": "2013-04-29",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "MAGGIE",
        "authorized_official_title_or_position": "CFO/COO",
        "authorized_official_telephone_number": "503-769-9236"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stayton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.