ADAPT (NPI# 1912061755) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1912061755 |
Entity Type | Organization |
Organization Name | ADAPT |
Other Organization Name | SOUTHRIVER MEDICAL CLINIC AKA: SOUTHRIVER COMMUNITY HEALTH CENTER |
Practice Address |
671 Sw Main Winston OR 97496-0012 |
Mailing Address |
P.o Box 12 Winston OR 97496-0012 |
Practice Telephone | 5414924550 |
Practice Fax Number | 5414924553 |
Mailing Telephone | 5414924550 |
Mailing Fax Number | 5414924553 |
Enumeration Date | 2006-12-19 |
Last Update Date | 2019-06-10 |
Authorized Official Name | MS. MICHELLE M WATSON (MANAGER) |
Authorized Official Telephone | 5414924550 |
Is Organization Subpart | Y |
Parent Organization Name | ADAPT |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
N | 261Q00000X | Clinic/Center | 276245 | OR | Ambulatory Health Care Facilities |
Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OR | 007151 | 05 |
Other Name | Type Code |
---|---|
SouthRiver Medical Clinic aka: SouthRiver Community Health Center | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508295668 | Adapt | Counselor | 1215 Se Court Ave, Roseburg, OR 97470-4329 | 2013-11-08 |
1174952238 | Adapt | Counselor | 550 Se Jackson St, Roseburg, OR 97470-4923 | 2013-11-08 |
1639508708 | Adapt | Counselor | 1036 Se Douglas Ave, Roseburg, OR 97470-3301 | 2013-11-08 |
1235568155 | Adapt | Counselor | 1950 Winchester Ave, Reedsport, OR 97467-1151 | 2013-11-01 |
1730362534 | Adapt | Substance Abuse Rehabilitation Facility | 2064 Se Douglas Ave, Roseburg, OR 97470-3713 | 2007-12-14 |
1649453440 | Adapt | Substance Abuse Rehabilitation Facility | 3099 Ne Diamond Lake Blvd, Roseburg, OR 97470-3655 | 2007-12-14 |
1144401043 | Adapt | Counselor | 418 Nw 6th St, Suite 102, Grants Pass, OR 97526-2006 | 2007-11-19 |
1750373346 | Adapt | Counselor | 548 Se Jackson St, Roseburg, OR 97470-4983 | 2005-08-18 |
1861967648 | Adapt | Clinic/Center | 671 Sw Main St, Winston, OR 97496-6571 | 2018-10-09 |
1497248025 | Adapt | Counselor | 400 Virginia Ave Ste 100, North Bend, OR 97459-3477 | 2018-06-08 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Oregon Corporations, Companies and Business Names | ADAPT | 621 W Madrone St, Roseburg, OR 97470 |
System for Award Management (SAM) Entities | ADAPT | 621 W Madrone St, Roseburg, OR 97470-3090 |
Colorado Business Entities | Adapt | 14260 E 104th Ave, 4-301, Commerce City, CO 80022 |
Oregon Corporations, Companies and Business Names | ADAPT & TRIUMPH | 2757 Nw 7th St Ste A, Redmond, OR 97756 |
Virginia Business Entities | AdaPt 2 HeaLing LLC | 1806 Summit Ave Ste 300, Richmond, Virginia 23230-4339 |
System for Award Management (SAM) Entities | ADAPT 2 IT, INC. | 24100 El Toro Rd Ste E, Laguna Woods, CA 92637-3129 |
System for Award Management (SAM) Entities | ADAPT A RAMP | 170 Fuller Rd Unit 6, Ajax, ON L1S 7G8, CAN |
New York State Corporations | ADAPT ABILITY INC. | 610 5th Ave., 1st Floor, Brooklyn, Ny 11215 |
New York State Corporations | ADAPT ACCESSIBILITY LLC | 2160 Penfield Road, Suite 11, Penfield, New York 14526 |
System for Award Management (SAM) Entities | ADAPT AD SPECIALTY | 13618 Lemay St, Van Nuys, CA 91401-1114 |
Street Address |
671 SW MAIN |
City | WINSTON |
State | OR |
Zip Code | 97496-0012 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912160169 | Kathryn Elizabeth Dailey | Social Worker | 671 Sw Main, Winston, OR 97496 | 2008-07-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679957708 | Second Wind Mental Health Clinic | Clinic/Center | 11 Sw Brantley Drive, Winston, OR 97496 | 2015-07-18 |
1992951305 | Ronald Forrest Tribble | Dentist | 90 Nw Glenhart, Winston, OR 97496 | 2008-08-18 |
1396923884 | Karen S Triplett | Nurse Practitioner | 92 Nw Glenhart Ave, Winston, OR 97496 | 2008-02-06 |
1629168166 | Adolescent Day Treatment Center Inc of Douglas County | Clinic/Center | 671 S.w. Main, Winston, OR 97496 | 2006-10-13 |
1184610123 | Ronald F. Tribble, Dmd, PC | Dentist | 90 Nw Glenhart Ave, Winston, OR 97496 | 2005-09-26 |
1083016695 | Cora G Hart | Psychologist | 671 Sw Main St, Winston, OR 97496 | 2014-09-25 |
1144426271 | Rebecca Lin Duffy | Nurse Practitioner | 311 Sw Main, Winston, OR 97496-0771 | 2007-06-25 |
1861843310 | Stacy J Nielsen, Lcsw, LLC | Community/Behavioral Health | 11 Sw Brantley Dr, Winston, OR 97496-4526 | 2016-06-27 |
1033462866 | Kathryn Vara | Registered Nurse | 77 Sw Brantley Dr, Winston, OR 97496-4526 | 2012-10-17 |
1154944536 | Functional Mental Health | Nurse Practitioner | 11 Sw Brantley Dr, Winston, OR 97496-4526 | 2020-05-20 |
Find all providers in zip 97496 |
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 |
---|---|---|---|---|
1861967648 | Adapt | Clinic/Center | 671 Sw Main St, Winston, OR 97496-6571 | 2018-10-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215540398 | La Clinica Del Valle Family Healthcare Center Inc. | Clinic/Center | 102 Christian Avenue, Talent, OR 97540 | 2020-08-28 |
1790398048 | La Clinica Del Valle Family Healthcare Center Inc. | Clinic/Center | 307 Wagner Creek Road, Talent, OR 97540 | 2020-08-26 |
1922656289 | Clackamas County | Clinic/Center | 39831 Highway 26, Sandy, OR 97055-6558 | 2019-08-29 |
1063067312 | Virginia Garcia Memorial Health Center | Clinic/Center | 11300 Sw Hazelbrook Rd, Tualatin, OR 97062-6980 | 2019-08-05 |
1417411505 | Klamath Health Partnership, Inc | Clinic/Center | 2210 N Eldorado Ave Ste A, Klamath Falls, OR 97601-6418 | 2019-01-23 |
1679053946 | Siskiyou Community Health Center Inc | Clinic/Center | 830 Ne 9th St, Grants Pass, OR 97526-1626 | 2018-08-16 |
1427563733 | Central City Concern Inc | Clinic/Center | 1415 Se 122nd Ave, Portland, OR 97233 | 2017-12-08 |
1598284242 | Winding Waters Medical Clinic | Clinic/Center | 401b N Main St, Joseph, OR 97846-5030 | 2017-09-13 |
1750807111 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 821 N Riverside Ave, Medford, OR 97501 | 2017-08-17 |
1477005619 | Outside In | Clinic/Center | 1226 Sw 12th Ave, Portland, OR 97205-2029 | 2016-11-03 |
Find all providers with the same taxonomy |
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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.