| Umpqua Community Health Center, Inc. | |
|
150 Kenneth Ford Dr Roseburg OR 97470-1042 | |
| (541) 672-9596 | |
| (541) 464-3519 |
| Full Name | Umpqua Community Health Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 150 Kenneth Ford Dr, Roseburg, Oregon |
| Authorized Official Name and Position | Kc Bolton (CEO) |
| Authorized Official Contact | 5416729596 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Umpqua Community Health Center, Inc. 150 Kenneth Ford Dr Roseburg OR 97470-1042 Ph: (541) 672-9596 | Umpqua Community Health Center, Inc. 150 Kenneth Ford Dr Roseburg OR 97470-1042 Ph: (541) 672-9596 |
| NPI Number | 1396751772 |
|---|---|
| Provider Enumeration Date | 07/31/2006 |
| Last Update Date | 06/28/2022 |
| Medicare PECOS PAC ID | 0345233078 |
|---|---|
| Medicare Enrollment ID | O20040511000463 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396751772 | NPI | - | NPPES |
| 168395 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Brad E Robinson |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1972688828 PECOS PAC ID: 7214998939 Enrollment ID: I20041025001106 |
| Provider Name | Beth E Blumenstein |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497727150 PECOS PAC ID: 9931121142 Enrollment ID: I20051230000309 |
| Provider Name | Jared E Juett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528286143 PECOS PAC ID: 2567540529 Enrollment ID: I20080416000591 |
| Provider Name | Stephanie A Riccalarsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447474945 PECOS PAC ID: 6709926397 Enrollment ID: I20091211000342 |
| Provider Name | Polly M Sepulvado |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1366433781 PECOS PAC ID: 6204978778 Enrollment ID: I20100121000390 |
| Provider Name | Shannon B Suhr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750514535 PECOS PAC ID: 9739210873 Enrollment ID: I20100706000384 |
| Provider Name | Kanani K Dilcher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427291350 PECOS PAC ID: 7911167895 Enrollment ID: I20120330000175 |
| Provider Name | Jay J Richards |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225214489 PECOS PAC ID: 4587898804 Enrollment ID: I20130927000599 |
| Provider Name | Steven W Jeffers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437338928 PECOS PAC ID: 5092907881 Enrollment ID: I20131204001865 |
| Provider Name | Heather R Holmes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124339544 PECOS PAC ID: 8628299484 Enrollment ID: I20141020000788 |
| Provider Name | Natalie A Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851660344 PECOS PAC ID: 0840511531 Enrollment ID: I20150605002492 |
| Provider Name | Kody J Seeley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336520162 PECOS PAC ID: 1254699804 Enrollment ID: I20180814002820 |
| Provider Name | Jennifer J Manson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174098180 PECOS PAC ID: 3072858968 Enrollment ID: I20181220003240 |
| Provider Name | Lorie T Decarvalho |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366480915 PECOS PAC ID: 2264512268 Enrollment ID: I20190122002472 |
| Provider Name | Robert L Dannenhoffer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1306873393 PECOS PAC ID: 9335239177 Enrollment ID: I20190729000013 |
| Provider Name | Amelia B Roth |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1659516557 PECOS PAC ID: 0840578886 Enrollment ID: I20191004003208 |
| Provider Name | Pamela Colleen Deornellas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558816553 PECOS PAC ID: 9234406422 Enrollment ID: I20200203001260 |
| Provider Name | Kirstin A Carhart |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1669742870 PECOS PAC ID: 9436372778 Enrollment ID: I20200228002485 |
| Provider Name | Steven Michael Prudencio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811366545 PECOS PAC ID: 6800170531 Enrollment ID: I20200402001997 |
| Provider Name | Lauren M Haddock |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1386127298 PECOS PAC ID: 5496009060 Enrollment ID: I20200903002815 |
| Provider Name | Meredith A Lafrance |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1144834912 PECOS PAC ID: 3476971524 Enrollment ID: I20200922001423 |
| Provider Name | Jonathan N Waller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801324264 PECOS PAC ID: 0840569133 Enrollment ID: I20200925000900 |
| Provider Name | Alim Karim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245610674 PECOS PAC ID: 8325394265 Enrollment ID: I20201103001226 |
| Provider Name | Heather J Stearman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699904383 PECOS PAC ID: 8022265560 Enrollment ID: I20201111001120 |
| Provider Name | Michael A Bigham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174155980 PECOS PAC ID: 0345652434 Enrollment ID: I20201214003085 |
| Provider Name | Deborah Ann Koopman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831741594 PECOS PAC ID: 2163752148 Enrollment ID: I20210105002625 |
| Provider Name | Valerie R Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144822644 PECOS PAC ID: 0941613160 Enrollment ID: I20210107002327 |
| Provider Name | Nathan James Andrews |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730685678 PECOS PAC ID: 5294086922 Enrollment ID: I20210824002002 |
| Provider Name | Cherann M Beer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497429583 PECOS PAC ID: 7618374711 Enrollment ID: I20210915003490 |
| Provider Name | Crystal Marie Hayes |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1609402601 PECOS PAC ID: 3971900077 Enrollment ID: I20210915003604 |
| Provider Name | Paige N Hosford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730794884 PECOS PAC ID: 4486045515 Enrollment ID: I20211229000572 |
| Provider Name | Derwood E Basham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053535120 PECOS PAC ID: 6800996141 Enrollment ID: I20220124002324 |
| Provider Name | Tiffany A Danforth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851750517 PECOS PAC ID: 4880927904 Enrollment ID: I20220428002784 |
| Provider Name | Virginia Ruth Terry |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1104924406 PECOS PAC ID: 2365823366 Enrollment ID: I20220722000496 |
| Provider Name | John Fardell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942838511 PECOS PAC ID: 5092186585 Enrollment ID: I20230726001472 |
| Provider Name | Tsz Ho Wong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750878484 PECOS PAC ID: 4688092612 Enrollment ID: I20230925000374 |
| Provider Name | Carmela Rosa Solimine |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1497531974 PECOS PAC ID: 0143675355 Enrollment ID: I20231009000696 |
A.k. Gombart M.d.p.c Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 532 W Umpqua St, Roseburg, OR 97470 Phone: 541-673-0133 | |
Roseburg Clinic Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2750 W Harvard Ave, Roseburg, OR 97471 Phone: 541-673-8988 Fax: 541-672-8103 | |
Douglas Medical Clinic Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1813 W Harvard Ave, Suite 201, Roseburg, OR 97470 Phone: 541-440-6390 Fax: 541-440-6392 | |
Laurence M Sharp Do Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1813 W Harvard Ave, Suite 426, Roseburg, OR 97471 Phone: 541-459-1611 Fax: 541-459-5741 | |
Bestmed Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1740 Nw Goetz Street, Roseburg, OR 97471 Phone: 541-672-4885 Fax: 541-672-4782 | |
Cow Creek Health & Wellness Ctr Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2589 Nw Edenbower Blvd, Roseburg, OR 97471 Phone: 541-672-8533 Fax: 855-670-1791 | |
Gordon F. Rose, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 544 W Umpqua St Ste 104, Roseburg, OR 97470 Phone: 541-673-3334 Fax: 541-673-0814 |