ST. CHARLES FAMILY CARE - PRINEVILLE
NPI 1407178528
Clinic/Center - Rural Health in Prineville, OR

NPI Status: Active since February 16, 2010

Contact Information

384 SE COMBS FLAT RD
SUITE 1200
PRINEVILLE, OR
ZIP 97754
Phone: (541) 447-6263
Fax: (541) 447-8724

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Authorized Official
CLIA Information
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Clinic/Center
Rural Health
Accepts Insurance
CLIA Number: 38D2203411
CLIA Cert. Type: Other - ANTICOAGULATION CLINIC
CLIA Exp. Date: 12-02-2026

About ST. CHARLES FAMILY CARE - PRINEVILLE

This page provides the complete NPI Profile along with additional information for St. Charles Family Care - Prineville, a primary care provider established in Prineville, Oregon operating as a Clinic/center, focusing in rural health . The healthcare provider is registered in the NPI registry with number 1407178528 assigned on February 2010. The practitioner's primary taxonomy code is 261QR1300X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as St. Charles Family Care - Prineville. The authorized official of this NPI record is Matthew Swafford (Cfo)

NPI: 1407178528
Provider Legal Name: ST. CHARLES HEALTH SYSTEM, INC.
Other Organization Name: ST. CHARLES FAMILY CARE - PRINEVILLE
Other Name Type: Doing Business As (3)
Entity Type: Organization
Location Address: 384 SE COMBS FLAT RD SUITE 1200 PRINEVILLE, OR 97754
Location Phone: (541) 447-6263
Location Fax: (541) 447-8724
Mailing Address: PO BOX 6095 BEND, OR 97708
Mailing Phone: (541) 382-4321
Mailing Fax: (541) 447-8724
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 02-16-2010
Last Update Date: 05-05-2023
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A primary care provider (PCP) like St. Charles Family Care - Prineville sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Clinic/Center Rural Health
Taxonomy Code: 261QR1300X
Type: Ambulatory Health Care Facilities

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Moda Health Plan, Inc.

Moda Health Affinity Bronze 7750 - EPO
Moda Health Affinity Bronze 9000 - EPO
Moda Health Affinity Bronze HDHP 7500 - EPO
Moda Health Affinity Gold 1000 - EPO
Moda Health Affinity Gold 1500 - EPO
Moda Health Affinity Gold 250 - EPO
Moda Health Affinity Silver 3000 - EPO
Moda Health Affinity Silver 3400 - EPO
Moda Health Affinity Silver 4500 - EPO
Moda Health Affinity Silver 6000 - EPO
Moda Health Oregon Standard Bronze Affinity - EPO
Moda Health Oregon Standard Gold Affinity - EPO
Moda Health Oregon Standard Silver Affinity - EPO

Providence Health Plan

HSA Qualified 7100 Bronze - Choice Network - EPO
Providence Oregon Standard Bronze Plan - Choice Network - EPO
Providence Oregon Standard Gold Plan - Choice Network - EPO
Providence Oregon Standard Silver Plan - Choice Network - EPO

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name: MATTHEW SWAFFORD
Authorized Official Title: CFO
Authorized Official Phone: (541) 382-4321

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State	Identifier Issuer
500642552	MEDICAID (05)	OR

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number: 38D2203411
Facility Type: Other - ANTICOAGULATION CLINIC
Certificate Effective Date: December 03, 2024
Certificate Expiration Date: December 02, 2026
Laboratory Director: KELLENE A. FISLER
Certificate Type: Certificate of Waiver
Certificate Type Description: This CLIA certificate is issued to St. Charles Family Care - Prineville to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	4	0	7	1	7	8	5	2	8
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	4	0	7	2	7	16	5	4
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 4 + 0 + 7 + 2 + 7 + 1 + 6 + 5 + 4 + 24 = 62
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 62 = 8									8

The NPI number 1407178528 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location

The following 14 providers are registered at the same or nearby location.

RONALD WILLIAM SPROAT MD

Surgery

384 SE COMBS FLAT RD
SUITE 1200
PRINEVILLE, OR
ZIP 97754

(541) 548-7761

View Profile

JAMES HOWARD LONG R. PH.

Pharmacist

(Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)