OHSU Scappoose Rural Health Clinic – Rural Health Clinic/Center, NPI 1417969304

OHSU Scappoose Rural Health Clinic is a healthcare provider. based in Scappoose, Oregon. specializing in Rural Health Clinic/Center. The NPI Number for OHSU Scappoose Rural Health Clinic is 1417969304

Main info

Organization
Name
OHSU Scappoose Rural Health Clinic
NPI
1417969304
Phone
(503) 418-4222
Address
51377 SW OLD PORTLAND RD
Authorized Official
KELLY ANNE SMITH VP/ENTERPRISE REVENUE CYCLE
Enumeration Date
12 August 2006
Last Update Date
12 September 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness90
Years active:19State licenses:0Digital endpoints

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Provider Addresses for OHSU Scappoose Rural Health Clinic

  • 51377, Southwest Old Portland Road, Scappoose, Columbia County, Oregon, 97056, United States

    SCAPPOOSE, OR 970564023

    Phone: (503) 418-4222

    Fax: (503) 418-4223

    Type: Location

  • 1400 SW 5TH AVE FL 5

    PORTLAND, OR 972015509

    Phone: (877) 943-2507

    Fax: (503) 494-4455

    Type: Mailing

  • Richard T. Jones Hall, 3181, Southwest Sam Jackson Park Road, Marquam Hill, Homestead, Portland, Metro, Multnomah County, Oregon, 97239, United States

    PORTLAND, OR 972393011

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-05-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20050411000642ORural Health ClinicORTBD
O20050516000173OClinic/Group PracticeORTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97056)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for OHSU Scappoose Rural Health Clinic?
OHSU Scappoose Rural Health Clinic — NPI 1417969304 — is the standard way to identify this listing.
Is OHSU Scappoose Rural Health Clinic still practicing?
OHSU Scappoose Rural Health Clinic is currently listed as active in the public NPI registry.
What is OHSU Scappoose Rural Health Clinic's specialty?
The listing groups OHSU Scappoose Rural Health Clinic with Rural Health Clinic/Center. Clinical services aligned with this taxonomy classification.
What address line appears for OHSU Scappoose Rural Health Clinic?
OHSU Scappoose Rural Health Clinic's geographic hint is Scappoose, Oregon in our summary view.
How many locations tie to this NPI?
3 practice locations appear in the available data.

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