WATERFORD AT THREE FOUNTAINS
NPI 1548205354
Skilled Nursing Facility in Medford, OR

NPI Status: Active since June 17, 2006

Contact Information

835 CRATER LAKE AVE
MEDFORD, OR
ZIP 97504
Phone: (541) 773-7717
Fax: (541) 857-5139

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  • Organization
  • Skilled Nursing Facility
  • CLIA Number: 38D2191656
  • CLIA Cert. Type: Assisted Living Facility
  • CLIA Exp. Date: 08-30-2026

About WATERFORD AT THREE FOUNTAINS

This page provides the complete NPI Profile along with additional information for Waterford At Three Fountains, a provider established in Medford, Oregon operating as a Skilled Nursing Facility. The healthcare provider is registered in the NPI registry with number 1548205354 assigned on June 2006. The practitioner's primary taxonomy code is 314000000X with license number 385126 (OR). The provider is registered as an organization and their NPI record was last updated 6 years ago. The provider's is doing business as Waterford At Three Fountains. The authorized official of this NPI record is Mr. Brian E Pryor (Vp Operations)

NPI
1548205354
Provider Legal Name
TOUCHMARK LIVING CENTERS, INC
Other Organization Name
WATERFORD AT THREE FOUNTAINS
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
835 CRATER LAKE AVE MEDFORD, OR 97504
Location Phone
(541) 773-7717
Location Fax
(541) 857-5139
Mailing Address
5150 SW GRIFFITH DR BEAVERTON, OR 97005
Mailing Phone
(503) 646-5186
Mailing Fax
(541) 857-5139
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-17-2006
Last Update Date
08-22-2020
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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

Skilled Nursing Facility

Taxonomy Code
314000000X
Type
Nursing & Custodial Care Facilities
License No.
385126
License State
OR
Taxonomy Description
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

Insurance Plans Accepted

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

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

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

MR. BRIAN E PRYOR

Authorized Official Title
VP OPERATIONS
Authorized Official Phone
(503) 646-5186

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
800545MEDICAID (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
38D2191656
Facility Type
Assisted Living Facility
Certificate Effective Date
August 31, 2024
Certificate Expiration Date
August 30, 2026
Laboratory Director
BRIAN E. PRYOR
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Waterford At Three Fountains 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.

Reviews for WATERFORD AT THREE FOUNTAINS

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1548205354, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
4
Doubled → 8
Pos 4
8
Unchanged
Pos 5
2
Doubled → 4
Pos 6
0
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
3
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 4 → 8 2 → 4 5 → 10 → 1 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 8 + 8 + 4 + 0 + 1 + 0 + 3 + 1 + 0 + 24 = 56

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 56 is 60. The difference is the calculated check digit.

60 - 56 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1548205354.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Physical Therapist (Geriatrics)
835 CRATER LAKE AVE
MEDFORD, OR 97504
Occupational Therapist
835 CRATER LAKE AVE
MEDFORD, OR 97504
Physical Therapy Assistant
835 CRATER LAKE AVE
MEDFORD, OR 97504
Physical Therapy Assistant
835 CRATER LAKE AVE
MEDFORD, OR 97504
Occupational Therapist (Gerontology)
835 CRATER LAKE AVE
MEDFORD, OR 97504
Occupational Therapist
835 CRATER LAKE AVE
MEDFORD, OR 97504
Podiatrist (Primary Podiatric Medicine)
835 CRATER LAKE AVE
MEDFORD, OR 97504
Occupational Therapist
835 CRATER LAKE AVE
MEDFORD, OR 97504
Family Medicine
835 CRATER LAKE AVE
MEDFORD, OR 97504
Physical Therapist
835 CRATER LAKE AVE
MEDFORD, OR 97504
Internal Medicine
835 CRATER LAKE AVE
MEDFORD, OR 97504
Speech-Language Pathologist
835 CRATER LAKE AVE
MEDFORD, OR 97504
Occupational Therapy Assistant
835 CRATER LAKE AVE
MEDFORD, OR 97504
Nurse Practitioner (Adult Health)
835 CRATER LAKE AVE
MEDFORD, OR 97504
Occupational Therapy Assistant
835 CRATER LAKE AVE
MEDFORD, OR 97504
Occupational Therapist
835 CRATER LAKE AVE
MEDFORD, OR 97504
Physical Therapy Assistant
835 CRATER LAKE AVE
MEDFORD, OR 97504
Occupational Therapy Assistant
835 CRATER LAKE AVE
MEDFORD, OR 97504
Physical Therapy Assistant
835 CRATER LAKE AVE
MEDFORD, OR 97504
Nurse Practitioner (Gerontology)
835 CRATER LAKE AVE
MEDFORD, OR 97504

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1548205354, enumerated as an "organization" on June 17, 2006.

The provider is located at 835 CRATER LAKE AVE MEDFORD, OR 97504 and the phone number is (541) 773-7717.

Skilled Nursing Facility with taxonomy code 314000000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.