SANTIAM MEDICAL CLINIC
NPI 1205048097
Family Medicine in Mill City, OR
About Santiam Medical Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SANTIAM MEDICAL CLINIC (NPI 1205048097) is a healthcare organization registered as a family medicine in Mill City, Oregon and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through November 14, 2027 and lists Shannon R Waddle, Office Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
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)
Santiam Medical Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
151Medicare enrollment records show 151 clinicians reassign Medicare billing to Santiam Medical Clinic, which bills Medicare for the services they deliver. Of these, 2 practice at this address. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 19
Nearest to this location (20)
See all 151Source: 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 38D0712188
Santiam Medical Clinic · Mill City, 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 Santiam Memorial Hospital's NPI number?
The NPI number for Santiam Memorial Hospital is 1205048097. It was assigned to this organization in the NPPES registry on May 4, 2007. The provider is doing business as Santiam Medical Clinic.
Where is Santiam Memorial Hospital located?
Santiam Memorial Hospital is located at 280 S First Ave, Mill City, OR 97360. The listed phone number is (503) 897-4100.
What is Santiam Memorial Hospital's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Santiam Memorial Hospital enrolled in Medicare?
Yes. Santiam Memorial Hospital is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Santiam Memorial Hospital?
According to the CMS Revalidation Reassignment List (October 2026 release), 151 clinicians in 19 Medicare specialties reassign their Medicare billing to Santiam Memorial Hospital. 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. The largest specialties are Diagnostic Radiology (27), Certified Registered Nurse Anesthetist (CRNA) (24) and Nurse Practitioner (22). Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Santiam Memorial Hospital hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 38D0712188) is associated with this NPI, valid through November 14, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Santiam Memorial Hospital accept?
Health plans from Providence Health Plan list Santiam Memorial Hospital 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 Santiam Memorial Hospital was last updated on September 28, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Santiam Medical Clinic · NPI 1205048097
Family Medicine organization in Mill City, Oregon. Organization record, active in the CMS NPPES registry since May 4, 2007.
## Identity
- **NPI:** 1205048097 (Entity type: Organization)
- **Enumerated:** May 4, 2007
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Santiam Memorial Hospital
- **Organization subpart:** No
- **Authorized official:** Shannon Waddle, OFFICE MANAGER
## Practice location
- **Address:** 280 S FIRST AVE, Mill City, OR 97360
- **Phone:** (503) 897-4100 · **Fax:** (503) 897-2673
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 151 clinicians in 19 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Diagnostic Radiology (27), Certified Registered Nurse Anesthetist (CRNA) (24), Nurse Practitioner (22); 2 practice at this address; [full list](https://npiprofile.com/npi/1205048097/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 28, 2016
- **Other identifiers:** Medicare PIN R112475 (OR)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1205048097) · Data from the CMS NPPES public registry.