EMERALD VALLEY ASSISTED LIVING
NPI 1902067036
Assisted Living Facility in Eugene, OR

NPI Status: Active since June 20, 2008

Contact Information

4550 W AMAZON DR
EUGENE, OR
ZIP 97405
Phone: (541) 345-9668
Fax: (541) 345-1190

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  • Organization
  • Assisted Living Facility
  • CLIA Number: 38D2096741
  • CLIA Cert. Type: Assisted Living Facility
  • CLIA Exp. Date: 05-31-2027

About EMERALD VALLEY ASSISTED LIVING

This page provides the complete NPI Profile along with additional information for Emerald Valley Assisted Living, a provider established in Eugene, Oregon operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1902067036 assigned on June 2008. The practitioner's primary taxonomy code is 310400000X with license number 1723683654 (OR). The provider is registered as an organization and their NPI record was last updated 17 years ago. The provider's is doing business as Emerald Valley Assisted Living. The authorized official of this NPI record is Elizabeth Marie Moss (Director Of Risk Management)

NPI
1902067036
Provider Legal Name
EUGENE LANE ASSOCIATES
Other Organization Name
EMERALD VALLEY ASSISTED LIVING
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
4550 W AMAZON DR EUGENE, OR 97405
Location Phone
(541) 345-9668
Location Fax
(541) 345-1190
Mailing Address
200 HAWTHORNE AVE SE STE A140 SALEM, OR 97301
Mailing Phone
(503) 588-2725
Mailing Fax
(541) 345-1190
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-20-2008
Last Update Date
06-20-2008
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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

Assisted Living Facility

Taxonomy Code
310400000X
Type
Nursing & Custodial Care Facilities
License No.
1723683654
License State
OR
Taxonomy Description
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

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

ELIZABETH MARIE MOSS

Authorized Official Title
DIRECTOR OF RISK MANAGEMENT
Authorized Official Phone
(503) 588-2725

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
524285MEDICAID (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
38D2096741
Facility Type
Assisted Living Facility
Certificate Effective Date
June 01, 2025
Certificate Expiration Date
May 31, 2027
Laboratory Director
AMANDA ROBY
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Emerald Valley Assisted Living 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.

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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.
1902067036
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2902061406
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 9 + 0 + 2 + 0 + 6 + 1 + 4 + 0 + 6 + 24 = 54
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 54 = 66

The NPI number 1902067036 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1902067036, enumerated in the NPI registry as an "organization" on June 20, 2008

The provider is located at 4550 W Amazon Dr Eugene, Or 97405 and the phone number is (541) 345-9668

This medical organization specializes in Assisted Living Facility with taxonomy code 310400000X

The provider might be accepting Accepts: 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 38D2096741 for a "assisted living facility" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued 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..

This NPI record was last updated on June 20, 2008. 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].
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