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UMPQUA COMMUNITY HEALTH CENTER, INC.
NPI 1619399888
Clinic/Center - Federally Qualified Health Center (FQHC) in Sutherlin, OR

Active since January 07, 2014
775 TAYLOR ST., SUTHERLIN, OR 97479(541) 672-9596 Get Directions Write a Review

NPPES record last updated: January 2, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Umpqua Community Health Center, Inc. NPPES

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

UMPQUA COMMUNITY HEALTH CENTER, INC. (NPI 1619399888) is a healthcare organization registered as a federally qualified health center (fqhc) in Sutherlin, Oregon and active in the NPI registry since January 2014. The organization maintains a secondary practice location in Sutherlin and lists Kc Bolton, Ceo, as its authorized official.

NPPES Registry Identity

NPI1619399888
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameUMPQUA COMMUNITY HEALTH CENTER, INC.
Location Address775 TAYLOR ST.Sutherlin, OR 97479
Mailing Address150 Ne Kenneth Ford DrRoseburg, OR 97470-1042 · (541) 672-9596 · Fax (541) 464-3519
Phone(541) 672-9596
Organization SubpartNo
Authorized OfficialKc BoltonCeo · (541) 672-9596
Enumeration DateJanuary 7, 2014
Last NPPES UpdateJanuary 2, 2024
NPPES CertifiedJanuary 2, 2024
✔ NPI 1619399888 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
Also ListedClinic/Center · Community HealthTaxonomy 261QC1500X
775 TAYLOR ST., Sutherlin, OR 97479
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Secondary Practice Location 1

Location 1123 Ponderosa DrSutherlin, OR 97479-9812 · Phone (541) 672-9596 ext. 114 · Fax (541) 464-3519

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.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)

Umpqua Community Health Center, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

52

Medicare enrollment records show 52 clinicians reassign Medicare billing to Umpqua Community Health Center, Inc., which bills Medicare for the services they deliver. Of these, 1 practice at this address and 21 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 14

Family Practice18
Nurse Practitioner10
Clinical Social Worker4
Registered Dietitian or Nutrition Professional4
Certified Nurse Midwife (CNM)3
Pediatric Medicine3
Mental Health Counselor2
Psychiatry2
6 other specialties6

Nearest to this location (20)

See all 52
Deborah Koopman, DNP, FNP
Nurse Practitioner
NPI 1831741594
775 TAYLOR STREET
Sutherlin, OR 97479
(541) 492-2087
✔ PECOS✔ Accepts MedicareSame address
Kody Seeley, DO
Family Practice
NPI 1336520162
123 PONDEROSA DR
Sutherlin, OR 97479
(541) 459-3788
✔ PECOS✔ Accepts Medicare0.5 mi
Tiffany Danforth, LCSW, CDC I
Clinical Social Worker
NPI 1851750517
150 SE KENNETH FORD DRIVE
Roseburg, OR 97470
(541) 492-6087
✔ PECOS8.3 mi
Eric Geisler, M.D.
Family Practice
NPI 1285684001
150 NE KENNETH FORD DR
Roseburg, OR 97470
(541) 672-9596
✔ PECOS✔ Accepts Medicare8.3 mi
Sean Phillips, D.O.
Family Practice
NPI 1962726612
150 NE KENNETH FORD DR
Roseburg, OR 97470
(541) 672-9596
✔ PECOS✔ Accepts Medicare8.3 mi
Polly Sepulvado, M.D.
Rheumatology
NPI 1366433781
150 NE KENNETH FORD DR
Roseburg, OR 97470
(416) 729-5965
✔ PECOS8.3 mi
Jay Richards, DO
Family Practice
NPI 1225214489
150 NE KENNETH FORD DR
Roseburg, OR 97470
(541) 672-9596
✔ PECOS✔ Accepts Medicare8.3 mi
Rita Barry, MD
Family Practice
NPI 1588097299
150 NE KENNETH FORD DR
Roseburg, OR 97470
(541) 672-9596
✔ PECOS✔ Accepts Medicare8.3 mi
Misha Peel, DO
Family Practice
NPI 1003374323
150 NE KENNETH FORD DR
Roseburg, OR 97470
(541) 672-9596
✔ PECOS✔ Accepts Medicare8.3 mi
Carmela Solimine
General Practice
NPI 1497531974
150 NE KENNETH FORD DR
Roseburg, OR 97470
(541) 672-9596
✔ PECOS✔ Accepts Medicare8.3 mi
Nathan Andrews, MD
Family Practice
NPI 1730685678
150 NE KENNETH FORD DR
Roseburg, OR 97470
(541) 672-9596
✔ PECOS✔ Accepts Medicare8.3 mi
Valerie Cooper, FNP-C
Nurse Practitioner
NPI 1144822644
150 NE KENNETH FORD DR
Roseburg, OR 97470
(541) 580-1148
✔ PECOS✔ Accepts Medicare8.3 mi
Lexi Kennedy, CSWA
Clinical Social Worker
NPI 1518696434
150 NE KENNETH FORD DR
Roseburg, OR 97470
(541) 672-9596
✔ PECOS✔ Accepts Medicare8.3 mi
Tsz Ho Wong
Family Practice
NPI 1750878484
150 NE KENNETH FORD DR
Roseburg, OR 97470
(541) 672-9596
✔ PECOS✔ Accepts Medicare8.3 mi
Robert Dannenhoffer, MD
Pediatric Medicine
NPI 1306873393
150 NE KENNETH FORD DR
Roseburg, OR 97470
(541) 672-9596
✔ PECOS✔ Accepts Medicare8.3 mi
Natalie Jones, FNP
Nurse Practitioner
NPI 1851660344
150 NE KENNETH FORD DR
Roseburg, OR 97470
(541) 672-9596
✔ PECOS8.3 mi
Kim Smith, LPC
Mental Health Counselor
NPI 1396132775
150 NE KENNETH FORD DR
Roseburg, OR 97470
(541) 672-9596
✔ PECOS8.3 mi
Kourosh Mehrazar, MD
Psychiatry
NPI 1972168219
2700 NW STEWART PKWY
Roseburg, OR 97471
(541) 673-0611
✔ PECOS✔ Accepts Medicare9.8 mi
Lauren Haddock, RD
Registered Dietitian or Nutrition Professional
NPI 1386127298
2371 NE STEPHENS ST STE 200
Roseburg, OR 97470
(541) 672-8533
9.9 mi
Steven Prudencio, FNP
Nurse Practitioner
NPI 1811366545
340 NW MEDICAL LOOP
Roseburg, OR 97471
(541) 464-5907
✔ PECOS✔ Accepts Medicare10.0 mi
See all 52 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Umpqua Community Health Center, Inc.'s NPI number?

The NPI number for Umpqua Community Health Center, Inc. is 1619399888. It was assigned to this organization in the NPPES registry on January 7, 2014.

Where is Umpqua Community Health Center, Inc. located?

Umpqua Community Health Center, Inc. is located at 775 Taylor St., Sutherlin, OR 97479. The listed phone number is (541) 672-9596.

What is Umpqua Community Health Center, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Is Umpqua Community Health Center, Inc. enrolled in Medicare?

Yes. Umpqua Community Health Center, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Umpqua Community Health Center, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 52 clinicians in 14 Medicare specialties reassign their Medicare billing to Umpqua Community Health Center, 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. The largest specialties are Family Practice (18), Nurse Practitioner (10) and Clinical Social Worker (4). Of these, 1 practice at this address and 21 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Umpqua Community Health Center, Inc. accept?

Health plans from Providence Health Plan list Umpqua Community Health Center, 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 Umpqua Community Health Center, Inc. was last updated on January 2, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.