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CANYONVILLE HEALTH AND URGENT CARE
NPI 1003210600
Internal Medicine in Canyonville, OR

Active since October 10, 2014CLIA 38D2107406 · Waiver
115 S PINE ST, CANYONVILLE, OR 97417(541) 839-4211(541) 839-4983 Get Directions Write a Review

NPPES record last updated: June 7, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 7, 2022, May 4, 2022 (2 updates tracked since 2022).

About Canyonville Health And Urgent Care NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CANYONVILLE HEALTH AND URGENT CARE (NPI 1003210600) is a healthcare organization registered as an internal medicine in Canyonville, Oregon and active in the NPI registry since October 2014. The organization holds a CLIA Waiver certificate valid through January 11, 2028 and lists Kristie Debaca, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1003210600
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameDR ANNA LLC
Location Address115 S PINE STCanyonville, OR 97417-9648
Mailing AddressPo Box 888Canyonville, OR 97417-0888 · (541) 839-4211 · Fax (541) 839-4983
Phone(541) 839-4211
Fax(541) 839-4983
Organization SubpartNo
Authorized OfficialKristie DebacaOffice Manager · (541) 391-4053
Enumeration DateOctober 10, 2014
Last NPPES UpdateJune 7, 20222 updates tracked since enumeration
NPPES CertifiedJune 7, 2022
✔ NPI 1003210600 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in OR · MD26035
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedClinical Medical LaboratoryTaxonomy 291U00000X
115 S PINE ST, Canyonville, OR 97417
Open in Google Maps ↗

Other Names 1

Doing Business AsCanyonville Health And Urgent Care

Other Identifiers 1

OtherR141355OR · Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 38D2107406

Canyonville Health And Urgent Care · Canyonville, OR
Active · expires Jan 11, 2028
CLIA Number38D2107406
Laboratory TypePhysician Office
Certificate Effective DateJanuary 12, 2026
Certificate Expiration DateJanuary 11, 2028
Laboratory DirectorAnandita Tiwari MD
Laboratory Phone(541) 839-4211
Laboratory LocationCanyonville Health And Urgent Care115 S Pine Street, Canyonville, OR 97417
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JON DOUGLAS GAMBILL PA-C
Physician Assistant (Medical)
115 S PINE ST
CANYONVILLE, OR 97417
Douglas County (541) 839-4211
RICHARD EDWARD COOKSLEY PA
Physician Assistant (Medical)
115 S PINE ST
CANYONVILLE, OR 97417
Douglas County (541) 839-4211
ANANDITA TIWARI M.D.
Internal Medicine
115 S PINE ST
CANYONVILLE, OR 97417
Douglas County (541) 839-4211

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dr Anna LLC's NPI number?

The NPI number for Dr Anna LLC is 1003210600. It was assigned to this organization in the NPPES registry on October 10, 2014. The provider is doing business as Canyonville Health And Urgent Care.

Where is Dr Anna LLC located?

Dr Anna LLC is located at 115 S Pine St, Canyonville, OR 97417. The listed phone number is (541) 839-4211.

What is Dr Anna LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Dr Anna LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 38D2107406) is associated with this NPI, valid through January 11, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Dr Anna LLC accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and Regence BlueCross BlueShield of Oregon list Dr Anna LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Dr Anna LLC was last updated on June 7, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.