LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC (NPI# 1417372731) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417372731 |
| Entity Type | Organization |
| Organization Name | LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC |
| Other Organization Name | BIRCH GROVE HEALTH CENTER- LA CLINICA |
| Practice Address |
910 S Central Ave Medford OR 97501-7822 |
| Mailing Address |
931 Chevy Way Medford OR 97504-4127 |
| Practice Telephone | 5416181380 |
| Practice Fax Number | 5416181385 |
| Mailing Telephone | 5415356239 |
| Mailing Fax Number | 5418422212 |
| Enumeration Date | 2014-02-24 |
| Last Update Date | 2019-07-15 |
| Authorized Official Name | TARA LYNETTE JEANNOT (CHIEF OPERATIONS OFFICER) |
| Authorized Official Telephone | 5415356239 |
| Is Organization Subpart | Y |
| Parent Organization Name | LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 022868 | 05 |
| Other Name | Type Code |
|---|---|
| Birch Grove Health Center | Other Name - Individual/Organization |
| Birch Grove Health Center- La Clinica | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942503248 | La Clinica Del Valle Family Health Care Center Inc | Clinic/Center | 4940 Hamrick Road, Central Point, OR 97502-3072 | 2010-12-09 |
| 1831492156 | La Clinica Del Valle Family Health Care Center Inc | Clinic/Center | 1307 W Main St, Medford, OR 97501-2936 | 2010-12-08 |
| Street Address |
910 S CENTRAL AVE |
| City | MEDFORD |
| State | OR |
| Zip Code | 97501-7822 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215127519 | Hillary Lynn Handelsman | Nurse Practitioner | 910 S Central Ave, Medford, OR 97501-7822 | 2007-08-01 |
| 1215568704 | Erica Davoren | Registered Nurse | 910 S Central Ave, Medford, OR 97501-7822 | 2020-02-03 |
| 1245860048 | La Clinica Del Valle Family Healthcare Center Inc. | Internal Medicine | 910 S Central Ave, Medford, OR 97501-7822 | 2020-01-21 |
| 1598309387 | Kelly Eileen Church | Registered Nurse | 910 S Central Ave, Medford, OR 97501-7822 | 2019-11-05 |
| 1184114696 | Judith Mackey | Nurse Practitioner | 910 S Central Ave, Medford, OR 97501-7822 | 2018-05-10 |
| 1366892598 | Peter Michael Millard | Nurse Practitioner | 910 S Central Ave, Medford, OR 97501-7822 | 2016-06-19 |
| 1346695236 | Nathaniel Fondell | Family Medicine | 910 S Central Ave, Medford, OR 97501-7822 | 2016-04-27 |
| 1821488875 | Dora Hebe Best | Counselor | 910 S Central Ave, Medford, OR 97501-7822 | 2015-01-29 |
| 1790108702 | Julianne T Curl | Nurse Practitioner | 910 S Central Ave, Medford, OR 97501-7822 | 2014-01-27 |
| 1063737252 | Laurel M Brown | Physician Assistant | 910 S Central Ave, Medford, OR 97501-7822 | 2010-03-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366069494 | Brian Snapp | Counselor | 1191 Hazel St, Medford, OR 97501 | 2020-07-06 |
| 1477174761 | Corey Renfree | Counselor | 1191 Hazel Street, Medford, OR 97501 | 2020-04-28 |
| 1669012928 | One of A Kind Therapy LLC | Social Worker | 916 West 10th St #205, Medford, OR 97501 | 2020-01-14 |
| 1265993620 | Star Dialysis LLC | Clinic/Center | 50 Rossanley Dr, Medford, OR 97501 | 2019-03-28 |
| 1962972463 | Karen Elise Roertgen | Counselor | 328 So. Central Ave., Suite 204, Medford, OR 97501 | 2018-11-28 |
| 1316458813 | Rick's Medical Supply, Inc | Durable Medical Equipment & Medical Supplies | 562 Parsons Drive, Suite 114, Medford, OR 97501 | 2017-10-24 |
| 1750807111 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 821 N Riverside Ave, Medford, OR 97501 | 2017-08-17 |
| 1992229009 | Cassandra Schultz | Massage Therapist | 824 East Jackson, Suite A, Medford, OR 97501 | 2017-07-31 |
| 1972962355 | Robin Clevenger | Peer Specialist | 301 S Ivy St, Medford, OR 97501 | 2016-02-15 |
| 1154706984 | Debbie Diane Orr | Behavioral Analyst | 1024 West 9th Street, Medford, OR 97501 | 2015-07-22 |
| Find all providers in zip 97501 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750807111 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 821 N Riverside Ave, Medford, OR 97501 | 2017-08-17 |
| 1497090971 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 713 Summit Avenue, Medford, OR 97501 | 2012-12-10 |
| 1073511721 | Rogue Community Health | Clinic/Center | 19 Myrtle Street, Medford, OR 97504-7337 | 2005-07-07 |
| 1275132466 | Rogue Community Health | Clinic/Center | 1000 E Main St, Medford, OR 97504-7667 | 2020-10-20 |
| 1184237489 | La Clinica Del Valle Family Healthcare Center Inc. | Clinic/Center | 1011 La Loma Dr, Medford, OR 97504-8613 | 2020-08-26 |
| 1578090221 | Rch Hep C Program | Clinic/Center | 900 E Main St, Medford, OR 97504-7136 | 2017-05-12 |
| 1548792245 | Rogue Community Health | Clinic/Center | 19 Myrtle St, Medford, OR 97504-7337 | 2017-03-31 |
| 1093266983 | Rogue Community Health | Clinic/Center | 906 Royal Ct, Medford, OR 97504-6139 | 2016-10-17 |
| 1023561560 | Rogue Community Health | Clinic/Center | 900 E Main St, Medford, OR 97504-7136 | 2016-08-02 |
| 1669848792 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 730 Biddle Rd, Medford, OR 97504 | 2015-08-12 |
| Find all providers in MEDFORD | ||||
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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.