COLUMBIACARE SERVICES INC (NPI# 1124534185) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124534185 |
| Entity Type | Organization |
| Organization Name | COLUMBIACARE SERVICES INC |
| Other Organization Name | PONY CREEK BOARD AND CARE |
| Practice Address |
2345 Marion St North Bend OR 97459-2637 |
| Mailing Address |
3587 Heathrow Way Medford OR 97504-4004 |
| Practice Telephone | 5412700219 |
| Mailing Telephone | 5418588170 |
| Mailing Fax Number | 5418588167 |
| Enumeration Date | 2017-12-28 |
| Last Update Date | 2017-12-28 |
| Authorized Official Name | MICHAEL SEWITSKY (FINANCE DIRECTOR) |
| Authorized Official Telephone | 5418588170 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QC1500X |
Clinic/Center Specialization: Community Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Pony Creek Board and Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861918278 | Columbiacare Services Inc | Community Based Residential Treatment Facility, Mental Illness | 2016 Terrel Dr, Medford, OR 97501-8154 | 2017-08-17 |
| 1861942096 | Columbiacare Services Inc | Clinic/Center | 201 W 6th St, Medford, OR 97501-2708 | 2016-10-12 |
| 1649466475 | Columbiacare Services Inc | Community Based Residential Treatment Facility, Mental Illness | 3587 Heathrow Way, Medford, OR 97504 | 2007-09-14 |
| Street Address |
2345 MARION ST |
| City | NORTH BEND |
| State | OR |
| Zip Code | 97459-2637 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093085110 | Angelene Logiudice | Counselor | 2345 Marion St, North Bend, OR 97459-2637 | 2012-01-05 |
| 1699283341 | Corey J Weber | Counselor | 2345 Marion St, North Bend, OR 97459-2637 | 2018-01-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568002749 | Ya-chi Claire Chang | Nurse Practitioner | 1229 1890 Waite St #1, North Bend, OR 97459 | 2020-01-15 |
| 1629573977 | Heather M Coates | Counselor | 400 Virginia Ave Ste 100, North Bend, OR 97459 | 2018-03-28 |
| 1205257219 | Melissa Sperry | Health Educator | 510 Lockhart Street, North Bend, OR 97459 | 2013-12-17 |
| 1265862627 | Elizabeth Sylvester | Counselor | 1592 Monroe Street, North Bend, OR 97459 | 2013-11-22 |
| 1124370291 | Brian Noble Thompson | Pharmacist | 3411 Broadway St., North Bend, OR 97459 | 2012-10-12 |
| 1295081230 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3411 Broadway St, North Bend, OR 97459 | 2012-07-27 |
| 1366728370 | Melissa Jean Kovach | Occupational Therapy Assistant | 3959 Sheridan Ave., North Bend, OR 97459 | 2011-10-24 |
| 1295045052 | Mary Kay Weikel | Massage Therapist | 3229 Broadway St Suite G Serenity Therapy Center, North Bend, OR 97459 | 2010-10-14 |
| 1902080013 | Anthony Eugene Baldacci | Registered Nurse | 1836 Meade Street, North Bend, OR 97459 | 2007-12-26 |
| 1952595340 | Inland Point Senior Estates Jv LLC | Clinic/Center | 2265 Inland Drive, North Bend, OR 97459 | 2007-08-29 |
| Find all providers in zip 97459 | ||||
| Taxonomy Code | 261QC1500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Community Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881293215 | Oregon Change Clinic | Clinic/Center | 650 Ne Holladay Street, Suite 1600, Portland, OR 97232 | 2020-10-17 |
| 1346850500 | Opportunity Connections, Inc. | Clinic/Center | 1102 12th St, Hood River, OR 97031-1602 | 2020-08-03 |
| 1750827184 | Elizabeth Villagrana | Clinic/Center | 32753 E Delaney St, Coburg, OR 97408-9265 | 2017-01-09 |
| 1811339666 | Oregon Health & Science University | Clinic/Center | 2952 Ne 34th Ave, Portland, OR 97212-2705 | 2013-07-22 |
| 1316268220 | Ruthie Faye Berrell | Clinic/Center | 1640 G Street, Springfield, OR 97477 | 2010-06-15 |
| 1588981096 | Joan Jackson Cavan | Clinic/Center | 86595 N Modesto Dr, Eugene, OR 97402-9045 | 2010-04-23 |
| 1639316193 | La Pine Community Health Center | Clinic/Center | 51600 Huntington Road, Suite C, La Pine, OR 97739-0001 | 2009-01-20 |
| 1376546291 | Willamette Family, Inc | Clinic/Center | 687 Cheshire Ave, Eugene, OR 97402-5060 | 2005-05-24 |
| 1457897548 | Lukedorf | Clinic/Center | 8915 Sw Center St, Tigard, OR 97223-6307 | 2017-01-12 |
| 1427594977 | Coast Community Health Clinic | Clinic/Center | 1010 1st St Se, Bandon, OR 97411-9301 | 2017-01-09 |
| Find all providers with the same taxonomy | ||||
| City | NORTH BEND |
| Zip Code | 97459 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.