Pacificsource Pace, LLC
NPI 1104787704ActiveOrganization· PACE Provider Organization· Springfield, OR
PACE Provider Organization in Springfield, Oregon, registered in NPPES in November 2025. The authorized official on file is Kristin Kernutt, JD, Chief Legal Counsel.
Overview
| NPI | 1104787704 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 21, 2025 |
| Last updated in NPPES | Jul 16, 2026 |
| Certified by provider | Jul 16, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| PACE Provider Organization Primary | 251T00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|