SISKIYOU COMMUNITY HEALTH CENTER, INC. – Federally Qualified Health Center (FQHC), NPI 1669638417

SISKIYOU COMMUNITY HEALTH CENTER, INC. is a healthcare provider. based in Grants pass, Oregon. specializing in Federally Qualified Health Center (FQHC). The organization holds a License No. 127725 (OR). The NPI Number for SISKIYOU COMMUNITY HEALTH CENTER, INC. is 1669638417

Main info

Organization
Name
SISKIYOU COMMUNITY HEALTH CENTER, INC.
NPI
1669638417
Phone
(541) 955-6053
Address
PO BOX 158
Authorized Official
RICHARD BOOTH CEO
Enumeration Date
31 July 2008
Last Update Date
6 October 2021
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience58
Completeness75
Years active:17State licenses:1Digital endpointsOther names

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Provider Addresses for SISKIYOU COMMUNITY HEALTH CENTER, INC.

  • PO BOX 158

    GRANTS PASS, OR 975280012

    Phone: (541) 955-6053

    Fax: (541) 471-9242

    Type: Mailing

  • Redwood Highway, Cave Junction, Josephine County, Oregon, 97531, United States

    CAVE JUNCTION, OR 975319724

    Phone: (541) 592-4111

    Type: Location

  • 1701 NW HAWTHORNE AVE

    GRANTS PASS, OR 975261051

    Phone: (541) 471-3455

    Fax: (541) 471-9242

    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: 2008-09-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

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
O20080916000486OFederally Qualified Health Center (Fqhc)ORTBD

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 97528)

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Reviews

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Frequently asked questions

Does SISKIYOU COMMUNITY HEALTH CENTER, INC. share an NPI with anyone else?
NPI numbers are unique to each provider or organization — SISKIYOU COMMUNITY HEALTH CENTER, INC. uses 1669638417.
Does CMS list SISKIYOU COMMUNITY HEALTH CENTER, INC. as active?
Yes — SISKIYOU COMMUNITY HEALTH CENTER, INC. is active in the NPI listing used on this page.
What taxonomy line describes SISKIYOU COMMUNITY HEALTH CENTER, INC.?
For research purposes, treat SISKIYOU COMMUNITY HEALTH CENTER, INC. as Federally Qualified Health Center (FQHC) in this dataset. Clinical services aligned with this taxonomy classification.
Does SISKIYOU COMMUNITY HEALTH CENTER, INC. list a practice location?
Patients near Grants Pass, Oregon may find SISKIYOU COMMUNITY HEALTH CENTER, INC. in results; validate coverage separately.
What does 'Organization' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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