NPIMap

Organization Active NPI

Valley Family Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Ontario, OR
National Provider Identifier
1992732291
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 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
Last updated
May 14, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
VALLEY FAMILY HEATLH CARE, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 14, 2021

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

Authorized official

Name
Jennifer Rodriguez
Title
Payer Enrollment Specialist
Phone
(208) 642-9376

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary
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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1992732291. Details of each certification follow.

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
CorporationNon-profit
Incorporated
Dec 30, 1981 in ID
Enrollment address
2327 SW 4TH Ave
Ontario, OR 97914-1851

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Part of
Valley Family Health Car

Locations

1020 E Locust St
Emmett, ID 83617
Phone (208) 365-5064

207 E 12th St
Emmett, ID 83617
Phone (208) 365-1065

840 SW 4th Ave
Ste 105
Ontario, OR 97914
Phone (541) 881-2500

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Joan I Delgado Individual Corporate OfficerBoard Member -Vice President Apr 20, 1997
Joanna Marie Strong Individual W-2 Managing EmployeePayor Enrollment Specialist May 24, 2021
Carolina Gomez Individual Corporate DirectorBoard of Directors May 4, 2022 100%
Kathy Oliver Individual Corporate DirectorBoard Member May 4, 2022 100%
Mike Allen Kee Individual Corporate OfficerBoard of Directors Jan 30, 2026 100%
Launee Trask Individual Corporate OfficerRevenue Cycle Director Jul 7, 2023 100%
Carlos Hernandez Individual Corporate OfficerBoard Member Jun 21, 1995 100%
Rick Bruce Lahuis Individual Corporate OfficerBoard Member Oct 28, 2021 100%
Shawna Dee Pierson Individual Corporate OfficerBoard Member-Secretary Feb 25, 2021 100%
Cheri L Hung Individual Corporate OfficerCfo Jan 25, 2023
Carolyn Wesner Individual Corporate OfficerBoard President May 28, 2020 100%
Mark Weldon Redmond Individual Corporate OfficerBoard of Directors Jul 26, 2023 100%
Daniel Ramirez Individual Corporate OfficerBoard Member Jan 27, 2022 100%
Yamileth Gonzalez Perez Individual Corporate OfficerBoard of Directors Nov 20, 2024 100%
Kenneth Robert Hart Individual Corporate OfficerBoard Member -Ceo Aug 24, 2020 100%
Corporate DirectorCeo Aug 24, 2020 100%
Benjamin Murray Individual Corporate OfficerBoard Member -Coo Dec 3, 2018 100%
Corporate DirectorCoo Dec 3, 2018 100%
Vicki L Crank Individual Corporate DirectorBoard Member Mar 24, 2022 100%

Practitioners & affiliated clinicians

Practitioners 39

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.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620950400000",
    "number": "1992732291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 NE 10TH AVE",
            "city": "PAYETTE",
            "state": "ID",
            "postal_code": "836615420",
            "telephone_number": "208-642-9376",
            "fax_number": "208-642-9598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2327 SW 4TH AVE",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979141851",
            "telephone_number": "541-889-2340",
            "fax_number": "541-889-2593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY FAMILY HEALTH CARE, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VALLEY FAMILY HEATLH CARE, INC",
        "enumeration_date": "2006-06-26",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PAYER ENROLLMENT SPECIALIST",
        "authorized_official_telephone_number": "208-642-9376"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, OR

Sources for this page

Verify at the official NPI Registry.