BIRCH GROVE HEALTH CENTER- LA CLINICA
NPI 1417372731
Clinic/Center - Federally Qualified Health Center (FQHC) in Medford, OR
NPI Status: Active since February 24, 2014
Contact Information
910 S CENTRAL AVE
MEDFORD, OR
ZIP 97501
Phone: (541) 618-1380
Fax: (541) 618-1385
- Organization
- Clinic/Center
- Federally Qualified Health Center (FQHC)
- Accepts Insurance
- CLIA Number: 38D2154062
- CLIA Cert. Type: Federally Qualified Health Center
- CLIA Exp. Date: 09-04-2026
About BIRCH GROVE HEALTH CENTER- LA CLINICA
This page provides the complete NPI Profile along with additional information for Birch Grove Health Center- La Clinica, a primary care provider established in Medford, Oregon operating as a Clinic/center, focusing in federally qualified health center (fqhc) . The healthcare provider is registered in the NPI registry with number 1417372731 assigned on February 2014. The practitioner's primary taxonomy code is 261QF0400X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The provider's is doing business as Birch Grove Health Center- La Clinica. The authorized official of this NPI record is Tara Lynette Jeannot (Chief Operations Officer)
- NPI
- 1417372731
- Provider Legal Name
- LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC
- Other Organization Name
- BIRCH GROVE HEALTH CENTER- LA CLINICA
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 910 S CENTRAL AVE MEDFORD, OR 97501
- Location Phone
- (541) 618-1380
- Location Fax
- (541) 618-1385
- Mailing Address
- 931 CHEVY WAY MEDFORD, OR 97504
- Mailing Phone
- (541) 535-6239
- Mailing Fax
- (541) 618-1385
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 02-24-2014
- Last Update Date
- 07-15-2019
- Code Navigator
A primary care provider (PCP) like Birch Grove Health Center- La Clinica 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 Federally Qualified Health Center (FQHC)
- Taxonomy Code
- 261QF0400X
- 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 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
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.
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 |
|---|---|---|---|
| 022868 | 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
- 38D2154062
- Facility Type
- Federally Qualified Health Center
- Certificate Effective Date
- September 05, 2024
- Certificate Expiration Date
- September 04, 2026
- Laboratory Director
- NATHANIEL FONDELL
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Birch Grove Health Center- La Clinica in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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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 | 1 | 7 | 3 | 7 | 2 | 7 | 3 | 1 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 2 | 7 | 6 | 7 | 4 | 7 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 2 + 7 + 6 + 7 + 4 + 7 + 6 + 24 = 69 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 69 = 1 | 1 | ||||||||
The NPI number 1417372731 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 15 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1215127519 | MS. HILLARY LYNN HANDELSMAN CNM, WHNP, NP Individual | Advanced Practice Midwife | 910 S CENTRAL AVE MEDFORD, OR 97501 (415) 370-4378 |
| 1184114696 | JUDITH MACKEY MSN, BA, APRN, FNP-C Individual | Nurse Practitioner (Family) | 910 S CENTRAL AVE MEDFORD, OR 97501 (541) 535-6239 |
| 1063737252 | LAUREL M BROWN PA Individual | Physician Assistant | 910 S CENTRAL AVE MEDFORD, OR 97501 (541) 618-1380 |
| 1790108702 | JULIANNE T CURL FNP Individual | Nurse Practitioner (Family) | 910 S CENTRAL AVE MEDFORD, OR 97501 (541) 618-1380 |
| 1215568704 | ERICA DAVOREN Individual | Registered Nurse | 910 S CENTRAL AVE MEDFORD, OR 97501 (541) 618-1380 |
| 1598309387 | KELLY EILEEN CHURCH FNP Individual | Nurse Practitioner (Family) | 910 S CENTRAL AVE MEDFORD, OR 97501 (541) 618-1380 |
| 1588949374 | HANNAH LOUISE BAMPTON N.P. Individual | Nurse Practitioner | 910 S CENTRAL AVE MEDFORD, OR 97501 (541) 618-1380 |
| 1346695236 | NATHANIEL FONDELL M.D. Individual | Family Medicine | 910 S CENTRAL AVE MEDFORD, OR 97501 (541) 618-1380 |
| 1699242081 | ERIKA HALEY CHAPMAN Individual | Counselor (Mental Health) | 910 S CENTRAL AVE MEDFORD, OR 97501 (541) 535-6239 |
| 1366892598 | PETER MICHAEL MILLARD CNP Individual | Nurse Practitioner (Psychiatric/Mental Health) | 910 S CENTRAL AVE MEDFORD, OR 97501 (541) 618-1380 |
| 1538877915 | KAROLYN A SAMUELS Individual | Registered Nurse | 910 S CENTRAL AVE MEDFORD, OR 97501 (541) 618-1380 |
| 1154026110 | SHELIE HUNT Individual | Community Health Worker | 910 S CENTRAL AVE MEDFORD, OR 97501 (541) 618-1380 |
| 1801400510 | STEVEN DIEGO CORDOBA Individual | Counselor (Mental Health) | 910 S CENTRAL AVE MEDFORD, OR 97501 (541) 618-1380 |
| 1578160586 | AUDREY ALLEN PHARM.D. Individual | Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist) | 910 S CENTRAL AVE MEDFORD, OR 97501 (541) 535-6239 |
| 1114652658 | CORA FRANTZ FNP-C, DNP Individual | Nurse Practitioner (Family) | 910 S CENTRAL AVE MEDFORD, OR 97501 (541) 535-6239 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1417372731, enumerated in the NPI registry as an "organization" on February 24, 2014
The provider is located at 910 S Central Ave Medford, Or 97501 and the phone number is (541) 618-1380
This medical organization specializes in Clinic/Center with taxonomy code 261QF0400X with a focus in Federally Qualified Health Center (FQHC)
The provider might be accepting Accepts: Moda Health Plan, Inc., Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 38D2154062 for a "federally qualified health center" facility with a CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP). This CLIA certificate is issued in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing..
This NPI record was last updated on February 24, 2014. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.