MILL CREEK FAMILY CLINIC INC
NPI 1114299153
Family Medicine in Salem, OR
About Mill Creek Family Clinic Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MILL CREEK FAMILY CLINIC INC (NPI 1114299153) is a healthcare organization registered as a family medicine in Salem, Oregon and active in the NPI registry since February 2012. The organization holds a CLIA Waiver certificate valid through February 26, 2028 and lists Peggy Nelene Kelber, Office Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mill Creek Family Clinic Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Mill Creek Family Clinic Inc, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 38D2037391
Mill Creek Family Clinic Inc · Salem, ORFrequently 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 Mill Creek Family Clinic Inc's NPI number?
The NPI number for Mill Creek Family Clinic Inc is 1114299153. It was assigned to this organization in the NPPES registry on February 7, 2012.
Where is Mill Creek Family Clinic Inc located?
Mill Creek Family Clinic Inc is located at 4285 Commercial St SE Suite 120, Salem, OR 97302. The listed phone number is (503) 391-6615.
What is Mill Creek Family Clinic Inc's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Mill Creek Family Clinic Inc enrolled in Medicare?
Yes. Mill Creek Family Clinic Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Mill Creek Family Clinic Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Mill Creek Family Clinic Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Mill Creek Family Clinic Inc hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 38D2037391) is associated with this NPI, valid through February 26, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Mill Creek Family Clinic Inc accept?
Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and Regence BlueCross BlueShield of Oregon list Mill Creek Family Clinic Inc 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 Mill Creek Family Clinic Inc was last updated on May 2, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Mill Creek Family Clinic Inc · NPI 1114299153
Family Medicine organization in Salem, Oregon. Organization record, active in the CMS NPPES registry since February 7, 2012.
## Identity
- **NPI:** 1114299153 (Entity type: Organization)
- **Enumerated:** February 7, 2012
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Peggy Kelber, OFFICE MANAGER
## Practice location
- **Address:** 4285 COMMERCIAL ST SE, SUITE 120, Salem, OR 97302-4371
- **Phone:** (503) 391-6615
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 2, 2012
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1114299153) · Data from the CMS NPPES public registry.