Valley Family Health Care, Inc
Organization Active NPI Federally Qualified Health Center (FQHC) · Ontario, OR
NPI 1992732291 · NPPES record last updated May 14, 2021
Key facts
- NPI
- 1992732291
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- VALLEY FAMILY HEALTH CARE, INC
- Practice address
- 2327 SW 4TH Ave
Ontario, OR 97914-1851 - Phone
- (541) 889-2340
- Fax
- (541) 889-2593
- NPI assigned
- Jun 26, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- VALLEY FAMILY HEATLH CARE, INC
Authorized official
- Name
- Jennifer Rodriguez
- Title
- Payer Enrollment Specialist
- Phone
- (208) 642-9376
Other NPIs on the same Medicare enrollment 6
Other NPIs with the same Medicare PAC ID 7
Practitioners 56
-
Mark Berger, NP
-
Holly M May, PA-C
-
Angela M Saitta, LCSW
-
Camryn Conrad-Renteria, LCPC
-
Christine Eileen Davenport-Welter, MD, MPH
-
Edwin Huhtala, DNP/FNP
-
Spencer Joseph Marsden, PA-C
-
Taylor Shane Shepherd, PA-C
-
Chris Richard Welter, M.D.
-
Lacey Wickersham, APRN
-
Tammie Jean Wilson, LPC
-
Sarah Nicole Wood, PA-C, MPH
-
Ryan Atwood, PA-C
-
Amber Mechelle Berger, PMHNP-BC
-
Marie Lynne Esplin, FNP
-
Bryon D Hemphill, DO
-
Brent Earl Kimbler, PA-C
-
Jeffrey Nowlin, PA C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OR
Federally qualified health center certification: CCN 381822
- Legal name
- VALLEY FAMILY HEALTH CARE INC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Mar 1, 1994
- Last certification
- Mar 1, 1994
- Ownership / control type
- For profit – partnership
- Organization structure
- Corporation · Non-profit
- Incorporated
- Dec 30, 1981 in ID
- Enrollment address
- 2327 SW 4TH Ave
Ontario, OR 97914-1851
All disclosed owners & managing parties 17
| Name | Role | Since | Share |
|---|---|---|---|
| Joan I Delgado |
Corporate Officer |
Apr 20, 1997 | |
| Joanna Marie Strong |
W-2 Managing Employee |
May 24, 2021 | |
| Carolina Gomez |
Corporate Director |
May 4, 2022 | 100% |
| Kathy Oliver |
Corporate Director |
May 4, 2022 | 100% |
| Mike Allen Kee |
Corporate Officer |
Jan 30, 2026 | 100% |
| Launee Trask |
Corporate Officer |
Jul 7, 2023 | 100% |
| Carlos Hernandez |
Corporate Officer |
Jun 21, 1995 | 100% |
| Rick Bruce Lahuis |
Corporate Officer |
Oct 28, 2021 | 100% |
| Shawna Dee Pierson |
Corporate Officer |
Feb 25, 2021 | 100% |
| Cheri L Hung |
Corporate Officer |
Jan 25, 2023 | |
| Carolyn Wesner |
Corporate Officer |
May 28, 2020 | 100% |
| Mark Weldon Redmond |
Corporate Officer |
Jul 26, 2023 | 100% |
| Daniel Ramirez |
Corporate Officer |
Jan 27, 2022 | 100% |
| Yamileth Gonzalez Perez |
Corporate Officer |
Nov 20, 2024 | 100% |
| Kenneth Robert Hart |
Corporate Officer |
Aug 24, 2020 | 100% |
| Corporate Director |
Aug 24, 2020 | 100% | |
| Benjamin Murray |
Corporate Officer |
Dec 3, 2018 | 100% |
| Corporate Director |
Dec 3, 2018 | 100% | |
| Vicki L Crank |
Corporate Director |
Mar 24, 2022 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040305000532 | OR | Part B Supplier - Clinic/Group Practice | 0547169591 |
Receives reassigned benefits from 74 practitioners 8 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Nyssa, OR; Ontario, OR; Vale, OR |
| O20081121000616 | OR | Part a Provider - Federally Qualified Health Center (FQHC) | 0547169591 | Practice locations: Ontario, OR |
National Provider Directory
- Part of
- Valley Family Health
Locations
840 SW 4th Ave
Ste 105
Ontario, OR 97914
Phone (541) 881-2500
789 Washington St W
Vale, OR 97918
Phone (503) 473-2101
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes | ||
| Multi-Specialty Clinic/Center | 261QM1300X |
Addresses
Primary practice location
2327 SW 4TH Ave
Ontario, OR 97914-1851
Mailing address
1441 NE 10TH Ave
Payette, ID 83661-5420
Phone (208) 642-9376
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 126875 | Medicaid | OR | |
| 002548700 | Medicaid | ID | |
| FQHC | Other | OR | COMMUNITY HEALTH CENTER |
| 002549000 | Other | ID | HEALTHY CONNECTIONS REF# |
Other providers in Ontario, OR
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- Valley Family Heatlh Care, Inc
- Paul Henry Van Egmond
- Jared Ross Van Orman
- Tyler R Van Wagenen
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All providers in Ontario, OR · Federally Qualified Health Center (FQHC) in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 14, 2021. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.